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Acute severe asthma in Trinidad and Tobago
Setting:
Accident and emergency department, General Hospital, Port of Spain, Trinidad and Tobago.
Objective:
To measure the occurrence and clinical management of acute severe asthma.
Design:
Data collected prospectively for consecutive attendees with asthma over a period of 3 months.
Results:
Asthma accounted for 8.8% of attendances. Treatment for the acute attack included nebulised salbutamol in 1031 (85%) and nebulised atrovent in 769 (63%). Systemic corticosteroids were given to 623 (51%) patients. Only 247 (20%) had planned follow-up arrangements recorded. Usual maintenance treatment included inhaled salbutamol in 767 (63%) and inhaled corticosteroid in 286 (24%). Inhaled corticosteroids were more often used by patients aged > or =15 years or who had had previous hospital admissions for asthma.
Conclusion:
The survey identified deficiencies in the clinical management of acute asthma attacks and in longterm asthma care. Caribbean guidelines for asthma care have subsequently been published, and follow-up surveys should be carried out to evaluate their implementation.