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Lessons from the national asthma mortality study: deaths in hospital
R P Rothwell1, H H Rea, M R Sears
1Waikato Hospital, Hamilton, Auckland.
The New Zealand Medical Journal
|April 8, 1987
Summary
Many hospital asthma deaths in New Zealand were preventable. Delays in seeking care and inadequate medical treatment contributed significantly to these tragic outcomes, highlighting a need for improved emergency asthma management.
Area of Science:
- Medical Research
- Pulmonary Medicine
- Epidemiology
Background:
- Analysis of 38 in-hospital asthma deaths in New Zealanders under 70 between 1981-1983.
- Focus on identifying preventable factors in asthma mortality.
Observation:
- Twelve deaths were deemed unavoidable, primarily in severe chronic asthmatics with optimal therapy.
- Six deaths resulted from patient/relative delays in seeking medical attention.
- Six deaths involved inadequate pre-hospital assessment and undertreatment by medical practitioners.
Findings:
- Four deaths were linked to delays and indecisiveness in Accident & Emergency (A&E) departments.
- Ten deaths occurred in hospital wards due to deficient assessment, monitoring, and treatment.
- No deaths were recorded in Intensive Care Units (ICUs).
Implications:
- Highlights the critical need for urgent expert assessment in A&E departments for acute severe asthma.
- Recommends ICU management for severe asthma cases requiring continuous oxygen, IV therapy, and prolonged monitoring.
- Suggests a review of pre-hospital and in-hospital asthma care protocols to reduce mortality.