Focused assessment of patients with asthma in the emergency department

Asthma remains a common cause for presentation to the emergency department. Multiple clinical asthma scores (CAS) have been developed to assess the severity of an asthma exacerbation. The objective of this retrospective study was to determine if adoption of a CAS and asthma guidelines identifies patients with more severe asthma and to identify factors that predict the need for hospital admission. The results identified the admission rates in the pre- and post-CAS groups to be similar. Within the post-CAS group, patients requiring admission received more aggressive therapy and were frequently hypoxic on initial presentation. In conclusion, CAS aids in identifying severe asthma exacerbations. Lack of response to aggressive therapy or hypoxia on initial presentation should prompt the emergency department physician to arrange for admission.