Asthma Care Practices in Chicago-Area Emergency Departments

McDermott, Michael F.; Grant, Evalyn N.; Turner-Roan, Karen; Li, Tao; Weiss, Kevin B.

doi:10.1378/chest.116.suppl_2.167s

Cited by 24 publications

(12 citation statements)

References 9 publications

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“…Still, our findings were consistent with those in the published literature that looked at both admitted and discharged patients (5,12,13,(15)(16)(17)19). Furthermore, our findings are consistent with those of Fitzgerald and Hargreave (18), who also looked specifically at the management of patients with asthma who were discharged from the emergency department.…”

Section: Discussionsupporting

confidence: 92%

“…Adherence to the emergency asthma management guidelines in the emergency department is often suboptimal (8,(12)(13)(14)(15)(16)(17)(18)(19). Specifically, two quality assurance audits that were performed within the Saskatoon Health District, Saskatchewan (performed in 1987 and 1990), showed that many management recommendations were not being followed in the emergency department.…”

Section: Traitement De L'asthme à L'urgence Objectifsmentioning

confidence: 99%

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Asthma Management in the Emergency Department

Reid¹,

Marciniuk²,

Cockcroft³

2000

Canadian Respiratory Journal

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OBJECTIVES:To evaluate various aspects of the management of adult patients who present to the emergency department with acute exacerbations of asthma and who are discharged from the emergency department without hospital admission. Further, to compare the results with accepted management guidelines for the emergency department treatment of asthma.DESIGN:A retrospective chart collection and review until each site contributed 50 patients to the survey.SETTING:Three tertiary care hospitals in the Saskatoon Health District, Saskatoon, Saskatchewan. The study period was from July 1, 1997 to November 18, 1997.POPULATION:Patients aged 17 years or older, who were discharged from the emergency department with the diagnosis of asthma.METHODS:Data were collected on 130 patients from 147 emergency department visits.RESULTS:A number of important physical examination findings were frequently not documented. In contrast to management guidelines, peak expiratory flow rates (44%) and spirometry (1%) were not commonly used in patient assessments. Only 59% of patients received treatment in the emergency departments with inhaled or systemic corticosteroids. Furthermore, specific follow-up plans were infrequently documented in the emergency department charts (37%).CONCLUSIONS:Adherence with published Canadian guidelines for the emergency department management of acute asthma exacerbations was suboptimal. Corticosteroid use in the emergency department was significantly less than recommended. Increased emphasis on education and implementation of accepted asthma management guidelines is necessary.

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Section: Discussionsupporting

confidence: 92%

Section: Traitement De L'asthme à L'urgence Objectifsmentioning

confidence: 99%

Asthma Management in the Emergency Department

Reid¹,

Marciniuk²,

Cockcroft³

2000

Canadian Respiratory Journal

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“…The current UHWI protocol does not include checking inhaler usage (10). These deficiencies were also seen in other asthma audits performed around the world, such as data collected from emergency departments in Chicago showed that less than 50% of their patients received any training on the use of an inhaler, received a written asthma action plan, or received a follow-up appointment at discharge (27). Similar complaints were made from studies done in Spain as well (16−17).…”

Section: Resultsmentioning

confidence: 77%

A Clinical Audit of the Management of Acute Asthmatic Attacks in Adults and Children Presenting to an Emergency Department

et al. 2014

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“…Despite such prevalence, several studies demonstrate extensive variation in care provided to asthmatic patients in the ED [1,2]. In an attempt to standardize care and improve patient outcomes [3], asthma clinical practice guidelines (CPGs) have been developed by national bodies [4,5], however their clinical use is limited.…”

Section: Introductionmentioning

confidence: 99%

Implementing an Integrative Multi-agent Clinical Decision Support System with Open Source Software

et al. 2010

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This paper describes the development of a tree-based decision model to predict the severity of pediatric asthma exacerbations in the emergency department (ED) at two hours following triage. The model was constructed from retrospective patient data abstracted from the ED charts. The original data was preprocessed to eliminate questionable patient records and to normalize values of age-dependent clinical attributes. The model uses attributes routinely collected in the ED and provides predictions even for incomplete observations. Its performance was verified on independent validating data (split-sample validation) where it demonstrated AUC (area under ROC curve) of 0.83, sensitivity of 84%, specificity of 71% and the Brier score of 0.18. The model is intended to supplement an asthma clinical practice guideline, however, it can be also used as a stand-alone decision tool.

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Asthma Care Practices in Chicago-Area Emergency Departments

Cited by 24 publications

References 9 publications

Asthma Management in the Emergency Department

Asthma Management in the Emergency Department

A Clinical Audit of the Management of Acute Asthmatic Attacks in Adults and Children Presenting to an Emergency Department

Implementing an Integrative Multi-agent Clinical Decision Support System with Open Source Software

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