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NRAD and Children

What the Report Means for Paediatric Care. NRAD and Children. 28 Children and Young People Died of Asthma. Age 4 – 19 yrs. Many Children Died Before Reaching Hospital. 8/10 (80%) children <10 yrs 13/18 (72%) children 10-19 yrs. Even Those With Mild/ Moderate Asthma Were At Risk.

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NRAD and Children

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  1. What the Report Means for Paediatric Care NRAD and Children Dr. James Paton University of Glasgow, Clinical Audit Lead, RCPCH

  2. 28 Children and Young People Died of Asthma Age 4 – 19 yrs

  3. Many Children Died Before Reaching Hospital 8/10 (80%) children <10 yrs 13/18 (72%) children 10-19 yrs

  4. Even Those With Mild/ Moderate Asthma Were At Risk 12/28 (42%) of children who died were thought to have mild / moderate asthma

  5. How Did the Children Die? • “Asthma Attacks” • Only 4 / 28 (14%) children had a record of • being provided with an Asthma Action Plan • How to spot when symptoms are getting worse • What to do when symptoms worsen • What to do in an emergency • When to call for emergency help Targeting Lung Attacks Fitzgerald Thorax 2011;66: 365-66

  6. Avoidable Factors – Families & Environment

  7. Adherence Matters! • ICS Adherence >80% was associated with better asthma control • Children with persistent mild symptoms had lower ICS adherence rates (p = .028) ERJ 2014; 43: 783-91

  8. Daily Hospital Admissions for Asthma among Children between 2000 and 2009 in Scotland Mackay et al N Engl J Med 2010; 363:1139-1145

  9. Avoidable Factors – Ongoing Medical Care/Supervision

  10. Asthma Deaths and Time of Year

  11. Quality of Care – Panel Conclusions

  12. Trends in Childhood Asthma Deaths Have Been Downwards

  13. But Children with Asthma Are Still Dying 2012 – 17 CF deaths in children <20 yrs1 2012 – 28 Asthma deaths in children <20yrs 1UK Cystic Fibrosis Registry Annual data report 2012

  14. What Does the Report Mean for Paediatric Care? • Always remember – children die of asthma – “Asthma Attacks” can kill • Everyone should have an asthma action plan • Good adherence can be achieved, and does matter • Passive smoking is bad for children with asthma • Do not forget psychosocial factors & asthma triggers • Meticulous attention to asthma guidelines will save lives

  15. NRAD Confidential Enquiry Panels

  16. Coding Accuracy - Panel vs Coding

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