Evidence map›Paper›PMID 37786991›Full record

Observational studyAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2024

Early Administration of Steroids in the Ambulance Setting: An Observational Design Trial (EASI-AS-ODT).

Jennifer N Fishe, Gerard Garvan, Andrew Bertrand, Shannon Burcham, Phyllis Hendry, Manish Shah, Kathryn Kothari, David W Ashby, Daniel Ostermeyer, Lauren Riney and 11 more

Open access · bronzeAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Cluster-Randomized Trials in Emergency Care Research.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 10 institutions in 1 country.

Jennifer N FisheDepartment of Emergency Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA.ORCID 0000-0001-9037-8143
Gerard GarvanCenter for Data Solutions, University of Florida College of Medicine, Jacksonville, Florida, USA.
Andrew BertrandDepartment of Emergency Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA.
Shannon BurchamUniversity of Florida College of Medicine, Gainesville, Florida, USA.
Phyllis HendryDepartment of Emergency Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA.
Manish ShahBaylor College of Medicine, Houston, Texas, USA.
Kathryn KothariBaylor College of Medicine, Houston, Texas, USA.
David W AshbyBaylor College of Medicine, Houston, Texas, USA.
Daniel OstermeyerMcGovern Medical School, University of Texas Health, Houston, Texas, USA.
Lauren RineyCincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Olga SemenovaCincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Benjamin AboLee County Emergency Medical Services, Fort Myers, Florida, USA.
Benjamin AbesLee County Emergency Medical Services, Fort Myers, Florida, USA.
Nichole ShimkoGolisano Children's Hospital of Southwest Florida, Fort Myers, Florida, USA.
Emily MyersSarasota County Fire Department, Sarasota, Florida, USA.
Marshall FrankFlorida State University College of Medicine, Tallahassee, Florida, USA.
Tim TurnerWalton County Fire Rescue, Defuniak Springs, Florida, USA.
Mac KempLeon County EMS, Tallahassee, Florida, USA.
Kim LandryLeon County EMS, Tallahassee, Florida, USA.
Greg RolandNassau County Fire Rescue Department, Yulee, Florida, USA.
Kathryn V BlakeNemours Children's Health, Jacksonville, Florida, USA.
University of Florida · USBaylor College of Medicine · USCincinnati Children's Hospital Medical Center · USFlorida Department of Health · USFlorida State University · USNew York City Fire Department · USGolisano Children's Hospital of Southwest Florida · USSarasota University · USSchool District of Lee County · USThe University of Texas Health Science Center · US

Funding

Early Administration of Steroids in the Ambulance Setting: An Observational Design TrialK23HL149991 · NHLBI · UNIVERSITY OF FLORIDA · PI FISHE, JENNIFER NOEL · 2020 to 2024
$729k
NHLBI NIH HHS K23 HL149991NHLBI NIH HHS K23HL149991
6 · The paper itself

Abstract

backgroundIn the emergency department (ED), prompt administration of systemic corticosteroids for pediatric asthma exacerbations decreases hospital admission rates. However, there is sparse evidence for whether earlier administration of systemic corticosteroids by emergency medical services (EMS) clinicians, prior to ED arrival, further improves pediatric asthma outcomes.

methodsEarly Administration of Steroids in the Ambulance Setting: An Observational Design Trial is a multicenter, observational, nonrandomized stepped-wedge design study with seven participating EMS agencies who adopted an oral systemic corticosteroid (OCS) into their protocols for pediatric asthma treatment. Using univariate analyses and multivariable mixed-effects models, we compared hospital admission rates for pediatric asthma patients ages 2-18 years before and after the introduction of a prehospital OCS and for those who did and did not receive a systemic corticosteroid from EMS.

resultsA total of 834 patients were included, 21% of whom received a systemic corticosteroid from EMS. EMS administration of systemic corticosteroids increased after the introduction of an OCS from 14.7% to 28.1% (p < 0.001). However, there was no significant difference between hospital admission rates and ED length of stay before and after the introduction of OCS or between patients who did and did not receive a systemic corticosteroid from EMS. Mixed-effects models revealed that age 14-18 years (coefficient -0.83, p = 0.002), EMS administration of magnesium (coefficient 1.22, p = 0.04), and initial EMS respiratory severity score (coefficient 0.40, p < 0.001) were significantly associated with hospital admission.

conclusionsIn this multicenter study, the addition of an OCS into EMS agency protocols for pediatric asthma exacerbations significantly increased systemic corticosteroid administration but did not significantly decrease hospital admission rates. As overall EMS systemic corticosteroid administration rates were low, further work is required to understand optimal implementation of EMS protocol changes to better assess potential benefits to patients.

Indexed as

AsthmaEmergency Medical ServicesAdolescentAdrenal Cortex HormonesAmbulancesChildEmergency Service, HospitalHumansSteroidsAdrenal Cortex HormonesSteroidsasthmaemergency medical servicespediatric asthmapediatric emergency medicinesystemic corticosteroids

Identifiers

PMID37786991
PMCPMC10842452
OpenAlexW4387297098

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.