Critical pathway for the emergency department management of acute asthma: Effect on resource utilization

Study objective: To determine the effect of a critical pathway on resource utilization in asthmatic patients. Methods: The study combined a prospective analysis of 149 patients with asthma treated by a pathway protocol with a retrospective analysis of 97 patients with asthma treated by conventional means. The setting was a community hospital. Results: Among patients treated by protocol, oxygen use declined by 19% (P=.001), handheld nebulizer treatments by 33% (P=.001), saline locks by 15% (P=.011), and intravenous steroid administration by 13% (P=.034). There was an increase in the use of metered-dose inhalers with spacer by 64% (P=.001) and oral steroids by 18% (P=.027). Conclusion: A critical pathway, based primarily on national guidelines, can be an effective means of treating asthma patients in terms of resource utilization.