Challenges in Implementing Evidence-Based Guidelines for Acute Pediatric Dyspnea: The Experience of El Alaa District Hospital
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Jihed Chemkhi Chemkhi
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- Keywords:
- Acute dyspnea,, Pediatric emergency care, Management
- Abstract
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Abstract :
Background: Acute dyspnea is a leading cause of pediatric emergency consultations. This study aims to describe the epidemiological, clinical, and therapeutic aspects of acute dyspnea in a Tunisian district hospital.
Methods: A descriptive cross-sectional study was conducted at El Alaa District Hospital in Kairouan,Tunisia from January to June 2025, including 52 children under 15 years presenting with acute dyspnea.
Results: The mean age was 3.8 years, with a male predominance (75%). Asthma (50.9%), bronchiolitis (29.4%), and laryngitis (19.6%) were the primary diagnoses. Management included bronchodilators for all asthma cases and nebulized adrenaline for all laryngitis cases. Regarding bronchiolitis, management showed significant variations from national guidelines: while nasopharyngeal suctioning was perfomed only to 66.6% of cases, corticosteroids were administered to 46.7% of infants, and antibiotic therapy was initiated in 33.3%, despite the absence of documented bacterial coinfection. Bronchodilators were also used in 40% of bronchiolitis cases. Overall, clinical improvement was achieved in 73.1% of the total cohort, while 26.9% required transfer to a specialized pediatric ward. No deaths were recorded.
Conclusion: Acute dyspnea in this setting is mainly due to asthma and bronchiolitis. While most cases are managed successfully at the district level, standardized protocols and caregiver education remain essential.
- References
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(8) Ben Ameur S, Elasmar K, Jdidi J, Belhadj R, Aloulou H, Maaloul I, Damak J, Kammoun T. General practitioners’ management of childhood asthma in Sfax, Tunisia. Rev Mal Respir. 2022 Dec;39(10):839–847. doi:10.1016/j.rmr.2022.09.006.
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- Published
- 30-06-2026
- Section
- Retrospective or cross-sectional study
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