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Biomedical subjects

E Barrell

Publications and source records attributed to E Barrell.

4 recordsLinked to original sources

Rising asthma admissions and self referral.

An eight fold rise in asthma admissions to the Royal Alexandra Hospital for Sick Children, Brighton occurred over the 15 year period 1971-85. The cause was an increase in the number of children seen, rather than increased readmission. The initial rise was associated with the introduction of nebulised salbutamol in 1976. The children concerned were mainly over 5 years old. Three years later came a larger influx of younger children. Circumstances leading to admissions were examined in a prospective study over a one year period. There were 605 admissions, 437 (72%) were self referrals. The commonest reason parents gave for preferring hospital treatment was the availability of nebuliser treatment.

Adolescent↗

Asthma in primary schools.

Seven schools in the Lewes area were visited to identify which children were using inhalational treatment for asthma. The attitudes of the parents and schools were assessed, as was the children's skill in using inhalers. Five per cent of all children were receiving inhalational treatment with bronchodilator drugs. On average they had missed seven school days in the past year. The opinions of the parents about treatment appeared to be determined by the severity of the child's asthma. Most schools coped well with giving bronchodilators, though there was no real understanding of the nature of the disease or treatment. Most children who had received pressurised inhalers could not use them satisfactorily.

Asthma↗

Effect of a single oral dose of prednisolone in acute childhood asthma.

140 children of 184 with acute asthma entered a randomised double-blind trial of oral prednisolone (n = 67) compared with placebo (n = 73) administered soon after admission. The dose of prednisolone was 30 mg in children under 5, otherwise 60 mg. All children also received salbutamol. All had moderate or severe dyspnoea. Initial evaluation was similar for both groups. On reassessment after a few hours 20 children in the prednisolone group were fit for discharge compared with only 2 in the placebo group. There were no early reattendances. Children remaining in hospital had a shorter median duration of stay and were less likely to require further steroid therapy if they had initially received prednisolone. In acute asthma the prompt use of a single dose of oral prednisolone can reduce morbidity and the need for hospital care.

Acute Disease↗