Comparison of Nebulizers in ED in Pediatric Asthma Patients
Condition: Asthma
MeSH terms: Asthma
Intervention: Hudson RCI® nebulizer; NebuTech® HDN® nebulizer; Albuterol
Intervention description: After the first hour of treatment, patients in the standard arm will receive a repeat assessment, including all of the measurements collected at baseline as well as reported side effects. Those patients who score PAS 0-2 will then be discharged home, after an optional observation period, as per the pathway. Those who score PAS > 2 will receive a second treatment. At the end of the second treatment patients will again be re-assessed, and repeat measurements obtained. At that time, depending on the patient's PAS score, he/she will be dispositioned to home, the floor, the pulmonary high acuity unit (PHAU), or the pediatric intensive care unit (PICU).; All treatments in the NebuTech® arm will be given at a standard dilution of 5 ml (diluted with normal saline to a total volume of 5 ml as per the manufacturer's recommendation). Patients in this arm will receive up to four treatments with parameters measured after each treatment, similar to the control arm. Patients who complete four treatments will then be dispositioned based on PAS score, similar to the control arm. Subjects may have started treatment prior to consent and may receives unit dose (2.5 mg) Albuterol/Proventil treatments will be given with a standard nebulizer up to 3 times as needed and may change over to study randomized device once consented to eith arm.; Subjects may have started treatment prior to consent and may receives unit dose (2.5 mg) Albuterol/Proventil treatments will be given with a standard nebulizer up to 3 times as needed and may change over to study randomized device once consented to eith arm.
Intervention MeSH terms: Albuterol
Phase: Phase 4
Study type: Interventional
Primary purpose: Supportive Care
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 40.0
Sex: All
Minimum age: 3 Years
Maximum age: 17 Years
Healthy volunteers: No
Keywords: Asthma; Asthma exacerbation

Summary:

      The primary objective will be, in an open-label randomized trial, a comparison of emergency
      department (ED) length of stay (LOS) between children experiencing acute asthma treated with
      two different nebulizers. Secondary outcomes will include admission rates, hospital LOS, need
      for additional therapies, transfers to a higher level of care, side-effects, and unscheduled
      return visits
    

Eligibility criteria:

        Inclusion Criteria:

          -  Age ≥ 3 years and < 18 years

          -  History of physician-diagnosed asthma

          -  Presenting to ED with acute asthma exacerbation according to attending physician

        Exclusion Criteria:

          -  PAS score < 3

          -  Immediate resuscitation required

          -  Chronic lung disease (other than asthma)

          -  Congenital heart disease 5. Neuromuscular disease 6. Suspected intrathoracic foreign
             body 7. Is or may be pregnant 8. Currently breast feeding 9. Oral or parenteral
             steroids within the last 7 days 10. Allergy or other contraindication to any of the
             study medications