# Treating Respiratory Emergencies in Children (T-RECS) Feasibility Study

> **NIH NIH R34** · OREGON HEALTH & SCIENCE UNIVERSITY · 2024 · $327,694

## Abstract

Over 200,000 children have a 911 Emergency Medical Services (EMS) activation for respiratory distress each
year, most of whom have acute wheezing. Early treatment in the prehospital setting could more rapidly relieve
respiratory distress symptoms, prevent hypoxia, reduce invasive interventions, and reduce the need to be
hospitalized, thereby facilitating earlier return to normal daily activities. Preliminary data from one site found
hospital admission was reduced from 30% to 21% among children when an EMS system introduced a pediatric
asthma protocol with oral dexamethasone. The current standard for Emergency Department (ED) treatment for
acute wheezing for children two and older includes inhaled ipratropium and dexamethasone. These treatments
have a longstanding history of safety and are effective in preventing hospitalization when used early in the ED.
Specific treatment protocols generally direct prehospital care. Ipratropium and dexamethasone are
recommended by national EMS organizations that develop model protocols for prehospital care. However, only
25% of EMS agencies from large US metropolitan areas allow ipratropium, and only 10% include
dexamethasone in their treatment protocols. A clinical trial is critically needed to evaluate whether the
significant EMS resources required to implement interventions for wheezing children that have proven benefit
in the ED result in improved patient outcomes. The overall objective of this three-site pilot trial is to address
specific questions related to the implementation of the study and ensure its feasibility. The study will be
conducted in the Pediatric Emergency Care Applied Research Network (PECARN) EMS Affiliates (EMSAs).
We will include patients aged 2-18 who have a 911 call for acute wheezing. The specific aims are 1) to develop
and produce a prehospital checklist for the treatment bundle including ipratropium and dexamethasone, 2) to
determine the feasibility of collecting patient outcomes for wheezing children treated in the EMS system, and 3)
to evaluate implementation of the EMS treatment bundle and checklist using the RE-AIM framework. This
study will provide the necessary data to ensure the eventual trial is feasible, primarily by establishing the ability
to measure the outcomes of interest as well as evaluating implementation. This study is innovative by focusing
on pediatric care in the prehospital environment, a critical component of our emergency care system that is
often neglected in research.

## Key facts

- **NIH application ID:** 10851670
- **Project number:** 5R34HL156887-02
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Matthew Lee Hansen
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $327,694
- **Award type:** 5
- **Project period:** 2023-06-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10851670

## Citation

> US National Institutes of Health, RePORTER application 10851670, Treating Respiratory Emergencies in Children (T-RECS) Feasibility Study (5R34HL156887-02). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10851670. Licensed CC0.

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