title: Acute asthma in a children's emergency room: a clinical audit and management guideline proposal.
abstract: BACKGROUND
  Adequate asthma control in children includes optimal medical management of acute exacerbations of the disorder. Asthma guidelines provide critical information and serve as quick reference decision-support material for clinicians.
  
  
  OBJECTIVE
  This clinical audit aimed at evaluating emergency management of acute asthma as well as proposing for use a management protocol, with the view of improving quality of care.
  
  
  METHODS
  This is a retrospective audit of the management of acute asthma over 18 months (October 2000-April 2002) Relevant data related to diagnostic and therapeutic procedures in thirty asthmatics were extracted and examined.
  
  
  RESULTS
  There were 20 males and 10 females (M:F ratio 2:1). Mean age (range) was 5.9 years (10 months-12.5 years) and mean (range) duration of symptoms prior to presentation was 1.9 days (2 hours-8 days). Trigger factors, current medications, clinical and functional indices of severity of acute asthma were not documented in 73.3%, 93.3% and 96.7% cases respectively. Diagnostic labels used in 28 (93.3%) did not reflect the acute nature or severity of the acute episode. Although nebulized salbutamol and oral corticosteroids were used for 80.0% of cases, aminophylline was frequently prescribed in addition. Discharge medications and instructions, including follow up in the respiratory clinic were not given in 21 (70.0%) and 28 (93.3%) cases respectively.
  
  
  CONCLUSIONS
  This audit noted that the overall management of acute asthma in the emergency room and the documentation of crucial information vital in the acute and long-term care of asthmatics were inadequate. We propose and recommend for use in the Children's Emergency Room, acute asthma management guideline and protocol-based asthma paper records as well as computerization of patient records.
authors.affiliation: Department of Paediatrics, Lagos University Teaching Hospital, Lagos. christyok@operamail.com
authors.forename: C A N
authors.initials: CA
authors.lastname: Okoromah
authors.forename: J K
authors.initials: JK
authors.lastname: Renner
authors.forename: A O
authors.initials: AO
authors.lastname: Oduwole
authors.forename: A O
authors.initials: AO
authors.lastname: Adenuga
mesh_terms: D000208:Acute Disease; D001249:Asthma / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004636:Emergency Service, Hospital; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008485:Medical Audit; D009549:Nigeria; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care