| Medical audit on children with asthma in an Emergency Department. | |
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MedLine Citation:
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PMID: 19775799 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To carry out a medical audit or evaluation and improvement procedure on the management of children with asthmatic crises in our Emergency Department (ED). MATERIAL AND METHODS: We carried out a retrospective audit between January and March 2007, analysing the medical records of a random sample of 50 patients aged 2-14 years consulting our ED for asthmatic crises. Following the international guides, we first selected 17 explicit indicators divided into four domains: "evaluation", "examination", "diagnostic resources", and "treatment and conditions at discharge". RESULTS: Indicators' compliance proved unequal; it was scarce for cause of asthma crisis (32%); degree of severity (18%); and supportive treatment (24%). Auscultation was registered in 100%, but respiratory frequency only in 49%, and peak flow in 0%. A total of 78% of the patients were treated in the ED, in all cases with beta-mimetic agents, and with systemic corticosteroids in 12%. The result of treatment was registered in only 69% of cases. The medical documentation of resident doctors was not signed by the staff. CONCLUSIONS: We identified the following weak points: failure to determine the degree of severity; lack of specification of the details of the crisis (prior duration, treatment at home, supportive treatment); scant asthma background history; and deficient recording of respiratory frequency and peak flow. We propose improving the anamnesis, recording respiratory frequency, with the introduction of tools to measure peak flow, specification of treatment response, and the development of a simpler and more practical protocol, with the performance of a re-audit. |
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Authors:
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M C de Mingo Alemany; A Campos Andreu; B Ferrer Lorente; R L??pez Salgueiro |
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Publication Detail:
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Type: Journal Article Date: 2009-09-23 |
Journal Detail:
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Title: Allergologia et immunopathologia Volume: 37 ISSN: 0301-0546 ISO Abbreviation: Allergol Immunopathol (Madr) Publication Date: 2009 Jul-Aug |
Date Detail:
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Created Date: 2009-10-13 Completed Date: 2010-01-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370073 Medline TA: Allergol Immunopathol (Madr) Country: Spain |
Other Details:
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Languages: eng Pagination: 198-202 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, La Fe University Hospital, Valencia, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Emergency Service, Hospital / standards* Guideline Adherence / standards* Hospitals, Pediatric / standards Humans Medical Audit / standards* Medical Records / standards Patient Discharge / standards Practice Guidelines as Topic / standards Retrospective Studies Spain Status Asthmaticus / diagnosis*, therapy* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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