| Journal: | Jornal brasileiro de pneumologia |
| Database: | PERIÓDICA |
| System number: | 000297446 |
| ISSN: | 1806-3713 |
| Authors: | Rocha, Persio Mariano da1 Fernandes, Andreia Kist Nogueira, Fernando Piovesan, Deise Marcela Kang, Suzie Franciscatto, Eduardo Millan, Thais Hoffmann, Cristine Polanczyk, Carisi Anne Barreto, Sergio Saldanha Menna Dalcin, Paulo de Tarso Roth |
| Institutions: | 1Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Rio Grande, Rio Grande do Sul. Brasil |
| Year: | 2004 |
| Season: | Mar-Abr |
| Volumen: | 30 |
| Number: | 2 |
| Pages: | 94-101 |
| Country: | Brasil |
| Language: | Portugués |
| Document type: | Artículo |
| Approach: | Caso clínico, analítico |
| English abstract | BACKGROUND: There is a wide variability in clinical practice for treating acute asthma (AA) in the emergency room (ER) interfering in the quality of management. OBJECTIVE: To evaluate the impact of a clinical protocol for care of acute asthma in the ER of the Hospital de Clínicas de Porto Alegre. METHOD: In this hospital a cross-sectional study was conducted before and after implementation of the protocol, of consecutive patients presenting with acute asthma in the adult ER (age > 12 years). The intention was to measure the effect of recommendations on the objective assessment of severity, utilization of diagnostic tools, proposed therapy, not recommended therapy and on the outcomes. RESULTS: The pre-protocol group comprised 108 patients and the protocol group comprised 96 patients. There was a significant increase in the use of pulse oximetry (8% to 77%, p<0.001) and PEFR (5% to 21%, p<0.001). There was an increase in the utilization of radiology (33% to 66%, p<0.001) and in that of blood tests (11% to 25%, p=0.016). There was also an increase in the number of patients receiving the three recommended nebulizations in the first hour (22% to 36%, p=0.04). Although the overall use of corticosteroids did not change, there was a significant increase in the use of oral steroids (8% to 28%, p<0.001). There was no significant difference in the not recommended therapy, time of stay and outcomes. CONCLUSION: The acute asthma clinical protocol used in the ER was associated to a positive effect on the objective assessment of severity of asthma and on the use of the recommended therapy. No other significant influence on the treatment or on the outcome was perceived |
| Portuguese abstract | CONCLUSÃO: A aplicação do protocolo assistencial de asma aguda na sala de emergência obteve efeito positivo, com maior utilização de medidas objetivas na avaliação da gravidade e de medidas terapêuticas recomendadas, porém não teve repercussão sobre tratamento e desfechos |
| Disciplines: | Medicina |
| Keyword: | Neumología, Otorrinolaringología, Asma, Protocolos clínicos, Urgencias médicas |
| Keyword: | Medicine, Otolaryngology, Pneumology, Asthma, Clinical protocols, Medical emergencies |
| Full text: | Texto completo (Ver HTML) |
