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EMS and ED disagree on paediatric asthma signs
Interobserver Agreement in Pediatric Asthma Examination Findings Between Emergency Medical Services and Emergency Department Clinicians
Prehospital Emergency Care · 2026-09-29 · Added 3 October 2026
Prospective study of 295 children transported with asthma exacerbations found only slight-to-fair agreement between EMS and ED clinicians on asthma severity exam findings, suggesting a prehospital paediatric asthma severity score would be hard to validate.
- Study type
- Cross-sectional
- Design
- Prospective observational agreement study
- Participants
- 295 children aged 2–18 at five paediatric EDs
- Main finding
- Slight agreement for suprasternal retractions (κ 0.01–0.20), fair for tachypnoea and accessory muscle use (κ 0.21–0.40), and poor agreement (ICC 0–0.50) for breathlessness, work of breathing, hypoxia and wheeze characteristics
- Caveat
- Convenience sample at five US paediatric EDs, with EMS surveys completed after ED arrival when the examination may already have changed
- Bottom line
- Context only
Why it matters in Australia (High relevance). Paediatric asthma is bread-and-butter for Australian crews, and the assessment-reliability problem is universal rather than system-specific.
Learning goal
Improve the reliability of my paediatric asthma severity assessment findings when handing over to receiving clinicians.
More
- Topic: Paediatrics
- Daily scan: 3 October 2026
- Podcast: Paramedic Papers Daily, 3 October 2026
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