A Model Protocol for Emergency Medical Services Management of Asthma Exacerbations

Abstract

Emergency medical services (EMS) is an important part of the continuum of asthma management. The magnitude of the EMS responsibility is very large, with millions of patients with asthma treated each year by EMS personnel. In response to inconsistencies between the 1997 National Asthma Education andPrevention Program asthma guidelines anda variety of existing EMS protocols on the management of asthma exacerbations, the Centers for Disease Control andPrevention convened a workgroup in 2004 to discuss the various opportunities andchallenges ahead. At the meeting, andover the ensuing year, the workgroup created a model protocol that was derived from the National Asthma Education andPrevention Program guidelines. The model protocol is available in both text andalgorithm format andoffers guidance for EMS systems to develop andimplement treatment protocols in their local areas. The workgroup recommendations emphasize flexibility, simplicity, andlow-risk practices. By integrating these recommendations into existing protocols, we believe that EMS systems could improve prehospital care for patients with asthma. Demonstration projects are needed to carefully examine the implementation process andthe actual impact of the model protocol on various outcomes. The workgroup also encourages more research on EMS management of asthma exacerbations. In the meantime, improved collaboration between EMS andnational asthma organizations is an immediate priority andwill continue to advance future discussions on how to improve asthma management in the prehospital setting. The workgroup hopes that state andlocal EMS systems will see the value of the model protocol andencourage its use. Key words: asthma; status asthmaticus; emergency medical services; ambulance; clinical protocols.