AN AUDIT AND INTERNATIONAL COMPARISON OF ASTHMA MANAGEMENT IN THE EMERGENCY DEPARTMENT

Aims. 1. To perform an audit of asthma management in the Christchurch Hospital emergency department during the period March 1987 to August 1 988. 2. To compare management of asthma in Christchurch with other cen tres in New Zealand and the United Kingdom. 3. To compare markers of a sthma severity on admission with other centres. Methods. Details of al l attendances by adults to the Christchurch Hospital emergency departm ent with acute asthma during the above period were recorded on special ly designed asthma treatment sheets. This data was compared with simil ar studies performed in Wellington (NZ) and Southampton and Leicester (UK). Results. 759 cases were analysed. Most subjects were in the 15-2 5 year age group. 47% were taking inhaled corticosteroids at presentat ion, History taking was satisfactory according to guidelines operative at that time. Peak flow rate measurement at presentation was performe d in 79% of cases, and in 67% of cases following treatment. Nebulised bronchodilators were given in 88% of cases and parenteral steroids giv en in 22%. 46% of cases were discharged home and of these 28% received a course of oral prednisone. All management decisions, except the dec ision to give oral steroids on discharge, showed a relationship to obj ective indices of asthma severity. Conclusion. Comparison with other c entres shows that the treatment of acute asthma in Christchurch was of a similar standard. Severity of asthma on presentation, as measured b y peak flow and pulse rates showed no difference between Christchurch and Southampton.