Audit strategies to reduce hospital admissions for acute asthma

An eightfold rise in hospital admissions for acute asthma from 1971-85 prompted two studies to audit the admissions policy at the Royal Alexandra Hospital. In the first study the on call senior house officer (SHO) was replaced by an experienced registrar and over a four month period 53 children out of 158 were sent home from the receiving room compared with six out of 39 seen by the SHOs. In the second study an SHO training programme was established together with a home treatment package. Over a 12 month period the on call SHOs assessed 687 children with acute asthma; 229 (43.5%) were deemed fit to be sent home. Only seven of these were readmitted within one week. Diary symptom score cards filled in by parents indicated that children sent home without admission fared no worsed at home than those admitted and then discharged for the two weeks after leaving hospital. The development of strategies to improve assessment and immediate management in the hospital receiving room can reduce hospital admissions for acute asthma, allowing more children to be safely managed in the community.</p

Surgical resection of a squamous cell carcinoma in the perianal region of a 25‐year‐old crossbred American Paint gelding using sharp surgical excision, laser excision and chemotherapy

A 25 year‐old American Paint gelding was referred to the Onderstepoort Academic Veterinary Hospital with an ulcerated lesion of nonpigmented skin at the right lateral aspect of the perianal region. An infiltrating squamous cell carcinoma was suspected. Surgical excision and ablation with sharp surgical excision and a diode laser was performed although complete excision was not possible due to the tumour location. Intralesional chemotherapy was performed at the completion of the surgical excision and continued in the post‐operative period. Histological examination of the excised lesion confirmed a diagnosis of squamous cell carcinoma and revealed incomplete resection margins at the medial, dorsal and ventral aspects of the surgical site. The surgical site healed uneventfully and a re‐examination at 6 months post‐surgery revealed the gelding to have normal clinical parameters with no perianal lesions.https://beva-onlinelibrary-wiley-com/journal/204232922020-12-01hj2020Companion Animal Clinical StudiesParaclinical Science