Critical pathway for the emergency department management of acute asthma: effect on resource utilization.
OBJECTIVE
To determine the effect of a critical pathway on resource utilization in asthmatic patients.


METHODS
The study combined a prospective analysis of 149 patients with asthma treated by a pathway protocol with a retrospective analysis of 97 patients with asthma treated by conventional means. The setting was a community hospital.


RESULTS
Among patients treated by protocol, oxygen use declined by 19% (P = .001), handheld nebulizer treatments by 33% (P = .001), saline locks by 15% (P = .011), and intravenous steroid administration by 13% (P = .034). There was an increase in the use of metered-dose inhalers with spacer by 64% (P = .001) and oral steroids by 18% (P = .027).


CONCLUSIONS
A critical pathway, based primarily on national guidelines, can be an effective means of treating asthma patients in terms of resource utilization.
Goldberg
R
R
Department of Emergency Medicine, Los Angeles County-University of Southern California Medical Center, USA. XFKT36A@prodigy.com
Chan
L
L
Haley
P
P
Harmata-Booth
J
J
Bass
G
G
D000208:Acute Disease; D000328:Adult; D000465:Algorithms; D001249:Asthma / Q000175:diagnosis / Q000451:nursing*; D002140:California; D019091:Critical Pathways; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital / Q000592:standards / Q000706:statistics & numerical data*; D004638:Emergency Treatment / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009730:Nursing Assessment; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014218:Triage