Referral recommendations for adult emergency department patients with exacerbated asthma

This consensus paper's purpose is to provide a tool for managing emergency asthma exacerbations that require a decision to admit or discharge the patient. The paper also addresses where to refer the discharged patient for follow-up. A multidisciplinary team of 3 emergency physicians, 3 specialists in respiratory medicine, and 3 allergy specialists were charged with drafting a list of clinical questions to answer by consulting practice guidelines and other resources in the literature. The specialists held a face-to-face meeting to distribute tasks and topics to working groups. The groups shared their reports, which provided the basis for drafting the final paper. The recommendations and flow charts included in the paper provide guidance for identifying and correctly diagnosing asthma exacerbations in the emergency department. Criteria for admission or discharge are incorporated. Treatment protocols and recommendations for referring discharged patients to specialists are addressed, along with criteria for priority referrals. The final consensus paper has been endorsed by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), the Spanish Society of Allergology and Clinical Immunology (SEAIC), and the Spanish Society of Emergency Medicine (SEMES).