[Treatment of severe acute exacerbation of asthma and chronic obstructive lung disease. An interview study].

Behandling af akut svaer eksacerbation af asthma og kronisk obstruktiv lungesygdom. En interviewundersøgelse.

Publisher: Den Alm Danske Laegerforening Country of Publication: Denmark NLM ID: 0141730 Publication Model: Print Cited Medium: Print ISSN: 0041-5782 (Print) Linking ISSN: 00415782 NLM ISO Abbreviation: Ugeskr Laeger Subsets: MEDLINE

Original Publication: Copenhagen : Den Alm Danske Laegerforening

Asthma/*therapy ; Lung Diseases, Obstructive/*therapy ; Status Asthmaticus/*therapy; Acute Disease ; Administration, Inhalation ; Anti-Asthmatic Agents/administration & dosage ; Asthma/diagnosis ; Asthma/drug therapy ; Bronchodilator Agents/administration & dosage ; Clinical Competence ; Denmark ; Emergencies ; Health Surveys ; Humans ; Lung Diseases, Obstructive/diagnosis ; Lung Diseases, Obstructive/drug therapy ; Monitoring, Physiologic ; Nebulizers and Vaporizers ; Oxygen Inhalation Therapy ; Practice Patterns, Physicians' ; Status Asthmaticus/diagnosis ; Status Asthmaticus/drug therapy ; Surveys and Questionnaires ; Telephone

Unlabelled: A telephone survey was conducted of all the 71 Danish hospitals with the capacity to receive acutely ill medical patients. The purpose was to register treatment regimes used in acute asthma and exacerbations in chronic obstructive pulmonary disease (COPD). The house officer on duty was interviewed and questioned about the use of nebulizers, oxygen therapy, bronchodilators, steroids, theophyllins and monitoring of the patient's condition. The physician survey was supplemented by a smaller survey among emergency room nurses about nebulizing systems. The answers showed inadequate knowledge of nebulizing systems. There was a noticeable variation in the dosing of oxygen and in the dosing of bronchodilators and steroids. beta 2-agonist treatment by nebulizer differed with a factor 14 in dose. The majority of the physicians had no specific parameters for monitoring severity of disease.
Conclusion: There is a need for improvement of the knowledge of nebulizing systems, including specific knowledge of the appropriate use of propellant gasflow and time of nebulizing for optimum performance of the used nebulizer. Divergent answers from the nurses and the physicians show the need for interdisciplinary instruction. The noticeable variation in treatment in this Danish survey displays a need for quality control in terms of concise guidelines for medical therapy in acute exacerbations of asthma and COPD and guidelines for monitoring of the response to the treatment. A suggestion for a treatment regime is proposed.

0 (Anti-Asthmatic Agents)
0 (Bronchodilator Agents)

Date Created: 19980107 Date Completed: 19971229 Latest Revision: 20151119

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