An audit and international comparison of asthma management in the emergency department.

AIMS

1. To perform an audit of asthma management in the Christchurch Hospital emergency department during the period March 1987 to August 1988. 2. To compare management of asthma in Christchurch with other centres in New Zealand and the United Kingdom. 3. To compare markers of asthma severity on admission with other centres.

METHODS

Details of all attendances by adults to the Christchurch Hospital emergency department with acute asthma during the above period were recorded on specially designed asthma treatment sheets. This data was compared with similar studies performed in Wellington (NZ) and Southampton and Leicester (UK).

RESULTS

759 cases were analysed. Most subjects were in the 15-25 year age group. 47% were taking inhaled corticosteroids at presentation. History taking was satisfactory according to guidelines operative at that time. Peak flow rate measurement at presentation was performed in 79% of cases, and in 67% of cases following treatment. Nebulised bronchodilators were given in 88% of cases and parenteral steroids given in 22%. 46% of cases were discharged home and of these 28% received a course of oral prednisone. All management decisions, except the decision to give oral steroids on discharge, showed a relationship to objective indices of asthma severity.

CONCLUSION

Comparison with other centres shows that the treatment of acute asthma in Christchurch was of a similar standard. Severity of asthma on presentation, as measured by peak flow and pulse rates showed no difference between Christchurch and Southampton.