If your child is having trouble breathing, what factors will influence your decision whether to take them to hospital?
Can you tell just how sick they are? Are you worried about waiting for hours in the emergency department? Would you rather not bother the ED staff and take them to your family doctor instead?
John Hunter Children's Hospital paediatric nurse and educator Bernadette Goddard, based in NSW's Hunter Valley, is examining such issues in a PhD study she hopes will arm families with information to improve their children's health outcomes.
Ms Goddard has won the NSW metropolitan division of the Humpty Dumpty Foundation's annual Michelle Beets Award for inspirational paediatric care.
The prize includes a $5000 bursary for professional development and $25,000 for equipment to help Hunter children with respiratory illnesses. The award recognises Ms Goddard's research and her efforts in setting up and running an asthma clinic at the hospital which helps assess and refer patients.
"If a child with asthma comes two or more times a year to an ED, that puts them at much higher risk of an adverse outcome," she said. "I'm going to look at these kids to see if there's something we're missing. How can we help these families."
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An important aspect of the research was investigating what affected parents' decisions about going to hospital.
"Parents will say, 'I don't want to sit in ED for five hours.' Much better sitting in ED for five hours than 10 minutes is resus," she said.
"When their child has trouble breathing, a common issue is they go to a GP. Forget the GP: Come to hospital. 'I don't want to bother ED,' is another one. If your child is having trouble breathing, you need to bother ED.
"Another issue is children do not appear as sick as they are. They will do everything to keep their oxygen up. Adults can't. And because they do that they don't look quite as sick until they absolutely are in a very bad way."
Ms Goddard said it was important to recognise that children with asthma, and their families, needed individualised care.
"You cannot care for a child with asthma; you have to care for a family of a child who has asthma. It's really about what's happening in their life and how we can educate and facilitate and support them with their situation, which is my research."
The NSW Ombudsman's 2018-19 biennial report into child deaths found respiratory illness to be the third leading cause of death in those aged one to four and the second leading cause in children aged five to nine.
"People think it's just asthma. But it's not just asthma. Asthma is extremely dangerous and life-threatening," Ms Goddard said.