Document Detail


Medical audit on children with asthma in an Emergency Department.
MedLine Citation:
PMID:  19775799     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M C de Mingo Alemany; A Campos Andreu; B Ferrer Lorente; R L??pez Salgueiro
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Publication Detail:
Type:  Journal Article     Date:  2009-09-23
Journal Detail:
Title:  Allergologia et immunopathologia     Volume:  37     ISSN:  0301-0546     ISO Abbreviation:  Allergol Immunopathol (Madr)     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-10-13     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370073     Medline TA:  Allergol Immunopathol (Madr)     Country:  Spain    
Other Details:
Languages:  eng     Pagination:  198-202     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, La Fe University Hospital, Valencia, Spain.
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MeSH Terms
Descriptor/Qualifier:
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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