P02S09: Respiratory distress (infant)

Bottom line: Information on respiratory distress was used to maintain the management of a patient (additional medication). There were no information-related patient health outcomes.

Level 1 outcome (situational relevance): On August 14, 2008, P02 did a search at work in the emergency department, by themselves, and during an encounter with a patient. They retrieved one information hit about paediatric dosing and dosage of Flovent. The reported search objective was to address a clinical question. “[In e-Therapeutics+], they have dosing guidelines for twelve months, but not younger and this child is ten months. […] It was a ten month old girl. […] This child came in with respiratory distress. Had a history of reactive airway disease which I guess you could say it’s similar to asthma. And the child was using pretty much a whole canister of Ventolin a month which is far too much. So we were discussing options to sort of control the symptoms. And Flovent was one that we discussed, so […] I went and again looked.” According to P02, e-Therapeutics+ was the only source for information, and the found information was relevant.

Level 2 outcome (cognitive impact): One hit was associated with a report of positive cognitive impact (see table). Regarding learning, P02 stated: “I guess I learned that there is no dosing guideline for those less than twelve months.”

Retrieved information hit(s):

1) e-Therapeutics+ (CIRT): e-CPS tab – Flovent HFA – dosage for children from 12 months to 4 years of age (P02S09H01)

Level 3 outcome (information use): Information on paediatric dosing and dosage of Flovent was retrieved, and used to maintain (be more certain about) the management of the patient (information used as presented in e-Therapeutics+; see below). “It says in there: “younger children [younger than 12 months] should be given one hundred micrograms twice daily. […] It was the dosing for them.[…] The patient wasn’t currently being treated with this and we needed to add something to control symptoms.”

Level 4 outcome (patient health): Without this information hit, P02’s management of the patient would have been the same. There were no clear relationships between the use of information and expected patient health outcomes.

Levels of outcome of information-seeking

Situational relevance	Positive cognitive impact	Information use	Patient health
Address a clinical question	Learned something Motivated to learn	Be more certain	No outcome

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