Premium
Managing asthma in accident and emergency departments: an assessment in non teaching hospitals
Author(s) -
Jayasuriya R.,
WestleyWise V.,
Dunn T.,
Nydam K.,
Jeffs D.
Publication year - 1993
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1993.tb04725.x
Subject(s) - medicine , asthma , audit , referral , accident and emergency , medical emergency , medical record , emergency medicine , demographics , family medicine , public health , patient referral , pediatrics , nursing , surgery , demography , management , sociology , economics
Background : The management and follow‐up of asthma patients presenting at Accident and Emergency (A&E) departments have mostly been studied in children's hospitals or specialised teaching hospitals. Aims : To study the adequacy of assessment, treatment and follow‐up of patients presenting at A&E departments in non‐teaching hospitals. Methods : A twenty‐five per cent sample of presentations to A&E departments in all public hospitals in the Illawarra for one year was selected for a case note audit. Information on demographics, assessment, management and referral was extracted from the A&E case notes and medical records of cases with documentation of a final diagnosis of asthma. Chi square and Fischer's Exact tests were used for comparisons among hospitals. Results : Of 359 presentations with a final diagnosis of asthma, 88% were self referred and only 5% were first presentations. Objective measures of airways obstruction was not documented in 34% of admissions and 48% of nonadmissions. There was no documented follow‐up in 28% of cases. The assessment and management of asthma in A&E was significantly poorer in smaller hospitals. Conclusion : Evidence of high use of A&E as a primary care facility by asthma patients was found in the study. There is a need to implement protocols to optimise assessment and treatment of asthma in smaller hospitals. (Aust NZ J Med 1993; 23: 672–677.).