Improving Prehospital Management of Children With Respiratory Distress

For prehospital providers, guidelines for managing children with respiratory distress are often based on expert opinion, extrapolated from studies in the inpatient or emergency department setting or studies with adult patients. Implementing research protocols to develop best practices for pediatric prehospital management is challenging due to the infrequent opportunities emergency medical services (EMS) providers have to provide care to pediatric patients. Critically ill or injured children with respiratory distress due to airway compromise or underlying illness such as severe asthma exacerbations are relatively low frequency but high risk events in the prehospital setting. Improving the pipeline from prehospital scientific research to clinical practice for higher quality evidence has been an Institute of Medicine (IOM) recommendation for over a decade. The objective of this article is to describe current evidence guiding prehospital management of children with respiratory distress and to discuss potential research opportunities.