Episode 66 – Acute Asthma

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Episode 66 – Acute Asthma

Episode 66 – Acute Asthma Exacerbations – An Interview with Dr. Steven Hochman and Dr. Brandon Somwaru

EMplify – February 2022

Emergency Department Management of Acute Asthma Exacerbations

Interview with the authors: Steven M. Hochman, MD, and Brandon Somwaru, DO

 

Episode Outline:

  • Epidemiology
  • Risk factors for death from asthma (Table 1)
  • Triggers for asthma attacks
  • Variants of asthma (Table 2)
  • Differential diagnosis (Table 3)
  • Can PE be a trigger for an acute asthma attack? 
  • Prehospital care
  • ED care: history (what should we ask?)
  • ED care: physical exam (what are we looking for?)
  • Classifying mild/moderate/severe asthma 
  • Lab studies
  • POCUS (Table 5 and Figure 3)
  • Peak expiratory flow
  • ETCO2 capnography and capnometry
  • Chest x-ray
  • Treatment (Table 6)
  • Medications
  • Oxygen
  • SABA vs LABA
  • What about MDIs?
  • Continuous nebs?
  • Anticholinergics
  • Steroids (IV, oral, inhaled; prednisone vs dexamethasone)
  • Magnesium sulfate
  • Epinephrine
  • Terbutaline
  • Ketamine
  • NIPPV
  • Intubation pearls and pitfalls (Table 8)
  • Special populations
  • Pediatrics 
  • Pregnancy
  • COVID-19 
  • Controversies and cutting edge
  • Biologics
  • Fractional exhaled nitric oxide
  • Heliox 
  • High flow nasal cannula
  • Delayed sequence intubation
  • ECMO
  • Disposition

Last Updated on July 3, 2022

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