Town I, Kwong T, Holst P, Beasley R
Department of Medicine, Wellington School of Medicine, New Zealand.
Thorax. 1990 Sep;45(9):702-6. doi: 10.1136/thx.45.9.702.
A standardised management protocol has been developed for the assessment and treatment of adults with acute asthma attending an emergency department. The management protocol consists of an assessment sheet for recording essential features of the history and examination findings and a flow diagram with guidelines for initial management that were based on spirometric recordings. The protocol was introduced at Wellington Hospital in 1986. The effect of this intervention was assessed by analysing emergency department records during the three months before and one year after the introduction of the protocol. The use of the assessment sheet improved history taking and led to the increased use of serial measures of airflow obstruction and improved documentation of follow up arrangements. The provision of management guidelines influenced the emphasis of management, including an increased use of corticosteroids intravenously and more frequent use of an additional dose of nebulised bronchodilator. In the light of the initial experience the protocol has been modified and its use either in an emergency department or in general practice is recommended.
已制定了一项标准化管理方案，用于评估和治疗到急诊科就诊的成年急性哮喘患者。该管理方案包括一张用于记录病史和检查结果基本特征的评估表，以及一张基于肺量计记录的初始管理指南流程图。该方案于1986年在惠灵顿医院推行。通过分析该方案推行前三个月和推行后一年的急诊科记录来评估这一干预措施的效果。评估表的使用改善了病史采集情况，使得气流阻塞系列测量方法的使用增加，随访安排的记录也有所改善。管理指南的提供影响了管理重点，包括静脉注射皮质类固醇的使用增加，以及额外剂量雾化支气管扩张剂的使用更加频繁。鉴于初步经验，该方案已作修改，并建议在急诊科或全科医疗中使用。
