| Emergency department management of exacerbation of chronic obstructive pulmonary disease: audit of compliance with evidence-based guidelines. | |
| | |
MedLine Citation:
|
PMID: 19811556 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
Background: Emergency departments (ED) play a key role in management of exacerbation of chronic obstructive airways disease (COPD). Current guidelines for management of exacerbation of COPD showed highest levels of evidence (Level A and B) were related to use of medications and non-invasive positive pressure ventilation (NIPPV). Aims: The aim of this study was to examine compliance with high level evidence for management of exacerbation of COPD during the first 4 h of ED care. Methods: A retrospective medical record audit was conducted at four public and one private ED in Melbourne, Australia. Participants were adult patients with COPD presenting to the ED with a primary complaint of shortness of breath from July 2006 to July 2007. Outcome measures were compliance with evidence-based recommendations regarding use of bronchodilators, methylxanthines, steroids and NIPPV. Results: Of 273 patients in this study, 72.4% received short-acting beta-agonist bronchodilators, 37.8% received an inhaled short-acting anticholinergic medication and 56.6% received systemic steroid therapy. NIPPV was used in 21 patients, 15 of whom had documentation of acidosis and/or hypercapnia). Conclusions: There was variation in the use of high level evidence for the ED management of exacerbation of COPD. The highest rate of compliance was non-use of methylxanthines and the greatest deficit was poor compliance with evidence related to NIPPV. There was also scope for improvement in the use of bronchodilators and systemic steroids. |
| | |
Authors:
|
J Considine; M Botti; S Thomas |
Related Documents
:
|
20576776 - The effect of recent amblyopia research on current practice in the uk. 9822516 - Is curettage needed for uncomplicated incomplete spontaneous abortion? 14682676 - The case for the use of evidence-based management research for the control of hospital ... 17467596 - Closing the theory-practice gap: intrapartum midwifery management of planned homebirths. 21310056 - Canadian clinical practice guidelines for acute and chronic rhinosinusitis. 21232426 - Implications of 'supply-side' ecology for environmental assessment and management. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Internal medicine journal Volume: 41 ISSN: 1445-5994 ISO Abbreviation: Intern Med J Publication Date: 2011 Jan |
Date Detail:
|
Created Date: 2011-01-26 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101092952 Medline TA: Intern Med J Country: Australia |
Other Details:
|
Languages: eng Pagination: 48-54 Citation Subset: IM |
Copyright Information:
|
© 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians. |
Affiliation:
|
School of Nursing, Deakin University-Northern Health Clinical Partnership, Melbourne, and School of Primary Health Care, Monash University, Melbourne, Victoria, Australia. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: What is the role of invasive versus non-invasive coronary angiography in the investigation of patien...
Next Document: Referral patterns to a palliative care service in rural Australia servicing indigenous Australians.