Source: International Congress 2014 – Management of asthma and other respiratory diseases in primary care
Disease area: Airway diseases

Abstract

Introduction: Adrenaline has been removed from the asthma guidelines for both the National Institute for Health and Clinical Excellence and Scottish Intercollegiate Guidelines Network. However the Joint Royal Colleges Ambulance Liaison Committee has retained it within their UK pre-hospital guidelines. Has their reluctance to remove adrenaline resulted in it being used excessively by ambulance crews?Aims: To assess whether adrenaline is overused in the treatment of asthma within the pre-hospital setting compared to other drug options.Method: All asthma related Patient Clinical Records (PCR) over a 12 month period were collated from within one UK ambulance service. Those PCRs where patients received adrenaline as part of their treatment regime were isolated and the data provided was then reviewed with a specific focus upon the presenting condition and the corresponding drug therapy provided.Results: Over this time frame 3,217 asthma related calls were attended and only 36 (1.1%) resulted in the patient receiving adrenaline as part of their treatment regime. Of these 36 patients; 1 (2.8%) received adrenaline as the first line drug; 20 (55.5%) received it as the second line drug; 12 (33.3%) received it as the third line drug and 3 (8.3%) received it as the fourth line drug. This group consisted of 17 (47.2%) patients with signs and symptoms (S&S) of an Acute Severe attack and 19 (52.8%) with S&S of a Life Threatening attack.Conclusion: The results show that despite being freely available, parenteral adrenaline has been solely administered by ambulance clinicians to asthma patients that are severely compromised and then only as part of a stepwise approach.

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Citations should be made in the following way:
C. Mortimer (Maidstone, United Kingdom). Is parenteral adrenaline used unnecessarily in the treatment of asthma patients in the pre-hospital setting?. Eur Respir J 2014; 44: Suppl. 58, 3023

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