Asthma emergency care: National guidelines summary

Abstract

The increasing global incidence of asthma and the availability of national guidelines for asthma treatment present an opportunity for emergency care providers to improve the delivery of care to patients. Despite the fact that the National Heart, Lung, and Blood Institute (NHLBI) published national guidelines in 1991 and an updated report in 1997, up to 49% of asthma patients continue to suffer from chronic and acute symptoms.1 One of the 6 NHLBI goals in asthma care is to minimize the need for emergency department visits or hospitalizations.2 Ironically, 32% of asthmatic children visited the emergency room, whereas 41% of all asthmatics sought urgent care from the emergency room, clinic, or hospital for acute exacerbation in the same year that the Expert Panel Report 2 (EPR2) was published, 6 years after publication of the Global Initiative for Asthma.3 More than 5000 people die each year of asthma1 and there were almost 2 million emergency room visits for asthma in 19953; these events often occur as a result of inadequate or inappropriate medical care. Prevention of acute exacerbations or deterioration is the ultimate goal of asthma-therapy, as outlined by the NHBLI guidelines. However, during an acute exacerbation, prompt action is required for stabilization to potentially prevent hospitalization, intubation, and unnecessary mortality. The most recent National Institutes of Health (NIH)/NHLBI guidelines regarding asthma emergency care are summarized in this article. (Heart Lung® 2001;30:472-4.)