title: A local perspective to asthma management in the accident and emergency department in Malta.
abstract: OBJECTIVE
  This study was performed to assess the management of adult patients presenting to the Mater Dei Hospital Accident and Emergency (A&E) department with acute asthma.
  
  
  METHODS
  Asthmatic patients age 14 or older who presented to A&E department between January and October 2010 with asthma exacerbations were included. Data were collected from the clinical notes and analyzed.
  
  
  RESULTS
  A total of 244 patients (67.2% females) were included, 126 (51.6%) were admitted, 97 (39.8%) discharged and 21 (8.6%) discharged themselves against medical advice. There was a decline in the presentations between January and July, followed by an upward trend until October (P = 0.42). Pulse oximetry was performed in 207 patients (84.8%), arterial blood gases in 133 (54.5%), peak expiratory flow rate in 106 (43.4%) and chest radiography in 206 (84.4%) patients. The respiratory rate was documented in 151 (61.8%), heart rate in 204 (83.6%) and ability to complete sentences in 123 (50.4%) patients. One hundred and ninety six patients (80.3%) were given nebulized bronchodilators, 103 (42.2%) intravenous corticosteroids, 7 (2.87%) oral corticosteroids, 109 (44.7%) oxygen, 28 (11.5%) antibiotics and 9 (3.69%) magnesium. Systemic corticosteroids and antibiotics were more commonly prescribed to patients admitted (P < 0.001).
  
  
  CONCLUSIONS
  Management of acute asthma in Malta requires optimization in order to compare with international guidelines.
authors: Department of Medicine, Mater Dei Hospital, B'Kara, Malta, Europe.
authors: Caroline
authors: C
authors: Gouder
authors: Josef
authors: J
authors: Micallef
authors: Rachelle
authors: R
authors: Asciak
authors: Justine Farrugia
authors: JF
authors: Preca
authors: Richard
authors: R
authors: Pullicino
authors: Stephen
authors: S
authors: Montefort
keywords: Accident and emergency department; adults; asthma exacerbations