Emergency department XXXX : compliance with an evidence-based management algorithm.

@entity1 @entity13265 @entity565 @entity3045 @entity228 @entity701
BACKGROUND: Recent surveys in emergency medicine departments show inadequacies in many aspects of acute @entity565 management. OBJECTIVE: The objective of this study was to evaluate the adherence to management algorithm for acute @entity565 in the emergency department which focused on evidence-based treatment steps rather than documentation and @entity1 classification. METHODS: A retrospective audit of consecutive adult @entity1 with acute exacerbations of @entity565 in the emergency medicine department of a university hospital managed in the context of a clinical algorithm. RESULTS: We collated information from 344 episodes of acute @entity565 (94% of total) over a 4-month period. The first-line treatment was nebulised bronchodilators in 97%, combination of @entity3045 and @entity13265 in 93% and the combination in recommended dosages in 87%. Systemic @entity228 treatment was administered to 82% of @entity1 . A further course of systemic @entity228 was prescribed at discharge for 94% of @entity1 . Overall, 93% of @entity1 received some form of systemic @entity228 treatment. The admission rate was 35.2%, and was significantly higher in @entity1 and the elderly. Of those who were admitted, 46.2% received > or = 3 nebulised treatments and 69% received intravenous @entity701 . CONCLUSIONS: In the management of acute @entity565 , we found excellent compliance with specific treatment steps based upon clinical evidence. However, adherence to second-line treatment was less satisfactory. Nevertheless, whenever second-line treatment was complied with, reasonable outcomes were achieved. It may be more appropriate to emphasise evidence-based treatment rather than extensive documentation.
