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급성 천식 발작 환자를 위한 표준치료지침의 운용 경험 : 효율성과 임상 경과

Other Titles
 Critical pathway of acute asthma attack for the Emergency Center: patients' outcomes and effectiveness 
Authors
 임동우  ;  박경희  ;  문일주  ;  김성렬  ;  고범석  ;  박혜정  ;  이재현  ;  박중원 
Citation
 ALLERGY ASTHMA & RESPIRATORY DISEASE, Vol.3(1) : 30-34, 2015 
Journal Title
ALLERGY ASTHMA & RESPIRATORY DISEASE
ISSN
 2288-0402 
Issue Date
2015
Abstract
Purpose: Early recognition and management of asthma attack is critical before it becomes worse. We developed critical pathway
(CP) of asthma attack at Emergency Center (EC) for making undelayed decision and management of asthma attack.
Methods: Acute asthma attack assessment and treatment (4AT) CP began on April 1st 2012 and recruited the patients for 18
months. This study enrolled the patients who were older than 15 years and visited EC for dyspnea and wheezing. Initial assessment
was done measuring peak expiratory flow rate (PEFR), oxygen saturation (SaO2). Once CP is activated, oxygen, inhalation of short
acting β2 agonist, and injection of corticosteroid were administered to the patients. Every hour after CP activated, we reassess the
patients’ response and make decisions whether to admit or discharge.
Results: Until January 10th 2014, 62 patients enrolled in this study. Seven patients hospitalized for asthma and 40 patients discharged.
The other 15 patients were deactivated as they were diagnosed of heart failure, myocardial infarction, aortic dissection,
anaphylaxis, chronic obstructive pulmonary disease and pneumonia for the causes of dyspnea. Mean Interval from EC arrival to 4AT
activation was 32.6±29.1 minutes and the mean interval from 4AT activation to position decision was 254.5±302.0 minutes.
Among 47 patients who were diagnosed with asthma attack, 13 patients were not aware of asthma before this attack. Forty patients
were discharged at EC after management of CP. Among them, 34 patients revisited clinic, but 6 patients did not. We called back to
the lost 6 patients but only 3 patients were connected. Even they visited EC due to asthma attack, 2 patients had no insight of importance
of regular management and the other one promised to revisit.
Conclusion: CP was successful for early management of asthma attack. However, 15% of discharged patients never show up again.
So, education program about the importance of ongoing management of asthma for prevention of asthma attack is needed.
Files in This Item:
T201506910.pdf Download
DOI
10.4168/aard.2015.3.1.30
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Beom Seok(고범석)
Kim, Sung Ryeol(김성렬) ORCID logo https://orcid.org/0000-0001-7418-0049
Moon, Il Joo(문일주)
Park, Kyung Hee(박경희) ORCID logo https://orcid.org/0000-0003-3605-5364
Park, Jung Won(박중원) ORCID logo https://orcid.org/0000-0003-0249-8749
Park, Hye Jung(박혜정) ORCID logo https://orcid.org/0000-0002-1862-1003
Lee, Jae Hyun(이재현) ORCID logo https://orcid.org/0000-0002-0760-0071
Leem, Dong Woo(임동우)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165822
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