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Snapshot of acute asthma: treatment and outcome of patients with acute asthma treated in Australian emergency departments

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Abstract:

Abstract Aims:

To characterize presentations due to acute asthma at Australian emergency departments (ED), including their severity, treatment and disposition. Methods:

This prospective, observational study involved 38 departments of emergency medicine throughout ­Australia participating in the Snapshot of Asthma Study Group project 2000 and 2001. Data were collected for patients presenting with acute asthma between 21 August 2000 and 3 September 2000, and 20 August 2001 and 2 September 2001 and included demographics, severity classification, treatment and disposition. Results:

There were 1340 acute asthma presentations in the study periods. Of these presentations, 67% were for children aged <15 years. Asthma severity (according to the Australian National Asthma Guidelines classifi­cation) was ‘mild’ in 49% of cases; ‘moderate’ in 45% of cases; and ‘severe’ in 6% of cases. Treatment administered included: (i) salbutamol to 90%, (ii) ipratropium bromide to 59% and (iii) corticosteroids to 71%. Only six patients received aminophylline. Spacer use for sal­butamol was rare (1%) in adults and only moderate (43%) in children. Sixty-five percent of patients were discharged home from the ED. Less than 1% of patients required ventilatory assistance, of which half was provided non-invasively. One percent of patients were admitted to the intensive-care unit or high-dependency unit. Conclusion:

Overall adherence to treatment guidelines was good. There appears to be underuse of spacers and corticosteroids in some groups and overuse of ipra­tropium bromide. The majority of patients are treated and discharged from the ED. (Intern Med J 2003; 33: 406−413)

Keywords: asthma; guidelines; management; outcome

Document Type: Original Article

DOI: http://dx.doi.org/10.1046/j.1445-5994.2003.00469.x

Publication date: September 1, 2003

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