Respiratory diseases pose a significant burden in pediatric emergency departments, highlighting the urgent need to address existing gaps in care. One concerning aspect is the high mortality rate associated with pneumonia in children under the age of 5. Pneumonia remains a leading cause of death worldwide among young children, particularly in low-income countries. Despite advances in medical knowledge and treatment options, access to appropriate healthcare, including timely diagnosis, effective antibiotics, and supportive care, remains limited in many regions. Closing this gap requires comprehensive strategies, such as improved access to healthcare facilities, increased vaccination coverage, and enhanced community-based interventions to prevent, diagnose, and manage pneumonia in young children.
Another respiratory condition that significantly impacts pediatric emergency departments is bronchiolitis. This viral infection primarily affects infants and young children, causing inflammation and obstruction in the small airways of the lungs. Bronchiolitis places a considerable burden on healthcare systems, with a substantial number of hospitalizations each year. However, there are inconsistencies in the management of bronchiolitis across different healthcare settings, leading to variations in care and potentially unnecessary interventions. Addressing these gaps necessitates the development and implementation of evidence-based guidelines, standardizing diagnostic criteria, and promoting appropriate supportive care measures to reduce hospitalizations and improve outcomes for children with bronchiolitis.
Asthma, a chronic respiratory condition, also contributes to the workload in pediatric emergency departments. It is one of the most common chronic diseases among children, and its prevalence has been increasing over the years. However, disparities in asthma management and outcomes persist, particularly among marginalized populations. Factors such as limited access to healthcare, inadequate asthma education, environmental triggers, and socioeconomic challenges contribute to these disparities. Efforts to bridge the gaps in asthma care should focus on promoting equitable access to healthcare services, ensuring proper asthma education for patients and caregivers, and implementing comprehensive strategies to address environmental triggers and social determinants of health.
In conclusion, respiratory diseases pose significant challenges in pediatric emergency departments. Gaps in care, including high under 5 pneumonia mortality rates, the burden of bronchiolitis, and disparities in asthma management, demand immediate attention. By implementing evidence-based guidelines, improving access to healthcare services, strengthening preventive measures, and addressing social determinants of health, we can strive towards reducing the burden of respiratory diseases among children and improving their overall outcomes.
Esther Sampayo is the site PI a multi-center international retrospective cohort study of eligible children with acute moderate and severe asthma exacerbations in the tertiary-care pediatric EDs associated with the Pediatric Emergency Medicine Networks (PERN).
Shubhada Hooli has worked extensively on the prevention of morbidity and mortality for young children with pneumonia in low- and middle-income countries (LMICs). She has served as a WHO consultant for childhood pneumonia and is a member of the WHO's Research Partnership to Assess WHO Recommendations (WHO PREPARE) and the Pediatric Acute Lung Injury and Sepsis Investigators Global Health (PALISI-GH) network.
Faculty with a research focus on respiratory disease:
- Gina Aloisio, M.D., Ph.D.: organoid respiratory virus models for bronchiolitis
- Email: Gina.Aloisio@bcm.edu
- Shubhada Hooli, M.D., MPH: pneumonia diagnosis and management
- Email: Shubhada.Hooli@bcm.edu
- Twitter: @Shubhada
- Esther M. Sampayo, M.D., MPH: asthma
- Email: Esther.Sampayo@bcm.edu
- Twitter: @md_ems
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