Table 2.
Acute asthma management in ED before and after implementation of PAMG.
| Asthma Management in ED | Retrospective N=278 |
Prospective N=154 |
p-value | ||
|---|---|---|---|---|---|
| n | % | n | % | ||
| Documentation in Medical Chart | |||||
| History of ED visit/hospitalization for asthma | 168 | 60.4 | 116 | 75.3 | 0.0021 |
| SaO2 at presentation | 260 | 93.9 | 151 | 98.1 | 0.0559 |
| SaO2 reassessment before discharge | 141 | 50.7 | 110 | 71.4 | < 0.0001 |
| Treatments and Tests in ED | |||||
| Oxygen | 9 | 3.2 | 15 | 9.7 | 0.0074 |
| Salbutamol | |||||
| Number of doses (Mean ± SD) | |||||
| In first hour | 2.0 ± 0.9 | 2.3 ± 0.9 | 0.0004 | ||
| In first 4 h | 3.1 ± 1.5 | 3.6 ± 1.4 | 0.0031 | ||
| Over ED stay | 3.7 ± 2.3 | 4.6 ± 2.5 | 0.0005 | ||
| Any | 231 | 83.1 | 149 | 96.8 | < 0.0001 |
| Ipratropium bromide | |||||
| Number of doses (Mean ± SD) | |||||
| In first hour | 2.0 ± 1.0 | 2.3 ± 0.9 | 0.0035 | ||
| In first 4 h | 2.6 ± 1.0 | 2.7 ± 0.9 | 0.3698 | ||
| Over ED stay | 2.7 ± 1.1 | 2.8 ± 1.1 | 0.2790 | ||
| Any | 184 | 66.2 | 119 | 77.3 | 0.0161 |
| Salbutamol combined with ipratropium bromide in patient with initial SaO2 ≤ 95% | 90 | 87.4 | 59 | 86.8 | 1.0000 |
| Oral corticosteroids | 167 | 60.1 | 129 | 83.8 | < 0.0001 |
| Chest x-ray | 68 | 24.5 | 46 | 29.9 | 0.2545 |
| Time between Processes (Minutes, Mean ± SD | |||||
| Entry of ED to bronchodilator treatment | 62.9 ± 66.5 | 78.8 ± 76.0 | 0.0334 | ||
| Entry of ED to corticosteroid treatment | 142.7 ± 88.6 | 125.0 ± 87.1 | 0.0901 | ||
| Bronchodilator treatment to physical exam reassessment | 52.0 ± 40.8 | 57.1 ± 47.9 | 0.3162 | ||
| Bronchodilator to SaO2 reassessment | 90.7 ± 95.4 | 94.6 ± 75.1 | 0.7258 | ||
| Asthma Education during ED Stay | |||||
| Assessed educational needs | 18 | 6.5 | 3 | 1.9 | 0.0370 |
| Addressed questions/concerns of child and family | 56 | 20.1 | 32 | 20.8 | 0.9011 |
| Disseminated asthma information package | 53 | 19.1 | 28 | 18.2 | 0.8978 |
| Educated on use of inhalation equipment | 81 | 29.1 | 47 | 30.5 | 0.8260 |
| Reviewed asthma triggers | 11 | 4.0 | 6 | 3.9 | 1.0000 |
| At least one of above | 88 | 31.9 | 53 | 34.4 | 0.5940 |
| Discharge Conditions | |||||
| Gooda | 142 | 93.4 | 86 | 96.6 | 0.3825 |
| SaO2 > 95% at last assessment | 99 | 70.2 | 74 | 67.3 | 0.6806 |
| Discharge planning | |||||
| Received instructions on follow-up appointment | 196 | 70.5 | 121 | 78.6 | 0.0705 |
| Received arrangement for referral to specialist | 4 | 1.4 | 4 | 2.6 | 0.4636 |
| Prescribed oral corticosteroids | 158 | 56.8 | 107 | 69.5 | 0.0101 |
| Prescribed inhaled corticosteroids | 187 | 67.3 | 106 | 68.8 | 0.7485 |
Note: All percentages have been adjusted for missing.
a
As indicated by ED physicians on the medical chart based on overall patient assessment at discharge.