Evaluation of a new ems asthma protocol in new york city: A preliminary report

Abstract

Background. In July 1996, the New York City (NYC) regional EMS implemented a new protocol whereby EMS personnel in the prehospital setting could administer 125 mg of intravenous methylprednisolone to asthma patients as one of their medical options following telephone consultation with a medical control physician. Objective. To determine whether this protocol had any effect on hospital admission rates or the emergency department (ED) length of stay. Methods. This retrospective chart review focused on the 219 (of 603 total) patients who arrived to the ED by ambulance over a two-year period whose ED diagnosis was asthma. There were 81 patient encounters in year 1, and 138 in year 2. Eleven of the year 2 group received prehospital steroids. The study took place at an urban 911 receiving, Level 2 ED. Results. Of the group who received prehospital steroids, none resulted in hospital admission. Due to the small sample size in the steroid-receiving group, the differences in these admission rates are not yet significant. No differences were detected in the ED length of stay between the two patient groups (157 vs 160 minutes in year 2, p = 0.9). Conclusion. The differences in admission rates suggested by this study suggest a simple yet potentially powerful tool for improving patient outcome in the treatment of asthma.

Key Words:

• Asthma
• Corticosteroids
• Methylprednisolone
• emergency medical services
• prehospital treatment.