# Early Administration of Steroids in the Ambulance Setting: An Observational Design Trial

> **NIH NIH K23** · UNIVERSITY OF FLORIDA · 2024 · $103,352

## Abstract

Program Director/Principal Investigator (Last, First, Middle): Fishe, Jennifer, N
K23 Abstract
Project Summary
Asthma is the most common chronic disease of childhood and a leading cause of emergency medical
treatment. Yet there is a paucity of evidence and guidelines for emergency medical services (EMS) treatment
of pediatric asthma prior to emergency department (ED) arrival. ED guidelines recommend early systemic
corticosteroid (CS) administration within one hour of ED arrival, since studies have shown associated
decreases in hospital admissions and ED length-of-stay (LOS). For patients treated by EMS, there exists an
opportunity for even earlier administration of CS. The goal of this project is to determine whether EMS
administration of CS improves patient outcomes. Our preliminary data demonstrate that currently less than
10% of EMS pediatric asthma patients receive CS prior to ED arrival.
Given the time-sensitivity of CS' effects on patient outcomes in the ED, our hypothesis is that EMS
administration of CS will decrease hospital admissions, ED LOS, and intensive care unit admissions. By
performing a pilot cluster randomized controlled trial, this study will fill a significant prehospital knowledge gap
in the continuum of emergent pediatric asthma care. This study analyzes cost and transport times, two factors
relevant to EMS operations and future guideline implementation. Through our partnership with Nassau County,
Alachua County and Lake County EMS agencies, we plan to enroll 330 patients over a three-year period to
analyze clinical outcomes and costs of EMS CS administration, and how both vary with EMS transport time.
During the five-year K23 career development award period, Dr. Jennifer Fishe will progress from a mentored
investigator to an independent investigator positioned to achieve R01 funding. That transition will occur due to
strong mentorship and a structured training plan which includes: 1) Development of knowledge and experience
with clinical trials, including protection of human subjects, 2) Attaining a Master of Science in Biostatistics, and
3) Grantsmanship and Leadership training necessary to become an independent investigator. Dr. Fishe's
mentor and scientific advisor team contains subject matter experts on clinical trials and pediatric asthma /
emergency medical services, experience with R01 grants and clinical trials, as well as career development.
PHS 398/2590 (Rev. 06/09) Page 1 Continuation Format Page

## Key facts

- **NIH application ID:** 10814767
- **Project number:** 5K23HL149991-05
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** Jennifer Noel Fishe
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $103,352
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10814767

## Citation

> US National Institutes of Health, RePORTER application 10814767, Early Administration of Steroids in the Ambulance Setting: An Observational Design Trial (5K23HL149991-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10814767. Licensed CC0.

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