A study of acute asthma in the accident and emergency department

We have conducted a survey of all the asthmatic patients seen at the Leicester Royal Infirmary Accident and Emergency Department during a 1-year period. A significantly greater number of patients were seen in the 8-hour period 1600-2359 hours and a greater number of patients were seen on Sundays and bank holidays. Wheeze was recorded in only 43% of the patients and there was no record of any nocturnal asthmatic symptoms. Peak expiratory flow rate was only recorded in 26% of patients before treatment with nebulized salbutamol (the commonest treatment). Pulse rate, respiratory rate, time of day or month did not determine whether or not a patient was admitted. We conclude that the education of junior doctors in the management of asthma is still deficient.