title: Emergency department asthma treatment protocol.
abstract: OBJECTIVE
  The purpose of this study was to determine if a brief educational intervention (INT) on the treatment of acute asthma improved prescribing patterns of internal medicine residents in an emergency department (ED). Additional objectives were to determine if optimal therapy reduced length of stay (LOS) in the ED and to determine if discharge prescribing patterns could be improved.
  
  
  METHODS
  Nonrandomized, single-blind INT study.
  
  
  METHODS
  A large, urban, county-owned, university-affiliated ED.
  
  
  METHODS
  Eight internal medicine residents in each of three study periods; numbers of adult asthmatics for each period were: control group, 129 (Nov-Dec 1989); INT group A, 82 (Jan-Feb 1990); and INT group B, 139 (Nov-Dec 1990).
  
  
  METHODS
  INT consisted of a ten-minute verbal presentation, a three-page summary of the literature, and a posted protocol in the ED. Control data were collected prior to any INT. Prescribing patterns were covertly evaluated in each of the three study periods. Because discharge prescribing of long-term antiinflammatory therapy with inhaled corticosteroids was not improved in group A, emphasis on this point was added for group B.
  
  
  METHODS
  Percentage of patients who received desired acute and discharge therapies and LOS for each study period.
  
  
  RESULTS
  Increased prescribing of desired acute therapy in the ED was seen in both INT groups. For discharge prescribing, the INT was partially successful. Reduced LOS was not found for the INT groups.
  
  
  CONCLUSIONS
  A brief INT effectively improves prescribing of optimal acute therapy of asthma in the ED, yet does not appear to reduce LOS. Further strategies are needed to impact on therapy prescribed at discharge from the ED.
authors.affiliation: UT Bowld Hospital, Memphis, TN 38103.
authors.forename: R H
authors.initials: RH
authors.lastname: Joe
authors.forename: A
authors.initials: A
authors.lastname: Kellermann
authors.forename: K
authors.initials: K
authors.lastname: Arheart
authors.forename: R
authors.initials: R
authors.lastname: Ellis
authors.forename: T
authors.initials: T
authors.lastname: Self
mesh_terms: D000328:Adult; D001249:Asthma / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D008875:Middle Aged