Prevalence of Asthma Severities in Children and Adolescents in a Wilmington, DE Hospital

Asthma affects over 24 million individuals in the US and the prevalence of the condition is increasing in the US and worldwide. The prevalence of severe persistent asthma, which incurs a significant health and economic burden, is still poorly understood in children and adolescents. We aimed to define the prevalence of asthma severities in children and adolescents in an urban hospital setting as a function of age, sex, race, and ethnicity by assessing prescribed medications as a proxy for asthma severity according to NIH guidelines for care. We found that a plurality of patients across all age groups, sexes, races, and ethnicities were severe persistent asthmatics. We also found that younger individuals as well as those who are African American have higher odds of being moderate to severe asthmatics. This information can be used to generate hypotheses for future studies and can be used to better address patient needs. In addition, these results suggest that a health disparity among African Americans exists that is consistent with other aspects of the condition. To reduce the prevalence of asthma in all populations, future research should place a greater emphasis on identifying more indicative risk factors for prevention, finding strategies to identify asthma at an earlier age, and developing more effective and personalized therapeutics

Simulation to improve trainee knowledge and comfort in managing maternal cardiac arrestAJOG Global Reports at a Glance

BACKGROUND: Maternal cardiac arrest is a rare outcome, and thus there are limited opportunities for specialists in obstetrics and gynecology to acquire the skills required to respond to it through routine clinical practice. OBJECTIVE: This study aimed to evaluate gaps in medical education in maternal cardiac arrest and whether a simulation-based training program improves resident knowledge and comfort in the diagnosis and treatment of maternal cardiac arrest. STUDY DESIGN: A 2-hour training for obstetrics and gynecology residents at an academic medical center was conducted, consisting of a didactic presentation, defibrillator skills station, and 2 high-fidelity simulations. Consenting residents completed a 21-item pretest followed by a 12-item posttest exploring knowledge of and exposure to maternal cardiac arrest. The McNemar and Wilcoxon signed-rank tests were used to compare pre- and posttest data. RESULTS: Of 21 residents, 15 (71.4%) had no previous education about maternal cardiac arrest, and 17 (81.0%) had never responded to a maternal code. Participants demonstrated increased knowledge about maternal cardiac arrest after the session, providing more correct answers on the reversible causes of pulseless electrical activity arrest (median 4 vs 7 correct responses; P<.01). After the training, more residents were able to identify the correct gestational age to perform a cesarean delivery during maternal cardiac arrest (19.0% vs 90.5%; P<.01) and the correct location for this procedure (52.4% vs 95.2%; P<.01). All residents reported that maternal cardiac arrest training was important and that they would benefit from additional sessions. Median composite comfort level in managing maternal cardiac arrest significantly increased after participation (pretest, 24.0 [interquartile range, 21.5–28.0]; posttest, 37.0 [interquartile range, 34.3–41.3]; P<.01). CONCLUSION: Residents report limited exposure to maternal cardiac arrest and desire more training. Simulation-based training about maternal cardiac arrest is needed during residency to ensure that graduates are prepared to respond to this high-acuity event

Book of Abstracts: 2019 Health Equity Summer Research Summit Organized by the Center of Excellence in Health Equity, Training and Research, Baylor College of Medicine, Houston, Texas 77030, USA on June 18th, 2019

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