Episode 66 – Acute Asthma

Take a deeper dive into our peer-reviewed emergency medicine content with the EMplify podcast. Join hosts Sam Ashoo, MD and T.R. Eckler, MD for educational, conversational reviews of current evidence guaranteed to help you make your best clinical decisions. Each high-yield episode gives you practical, time-tested guidance from practicing emergency medicine clinicians and subject-matter experts. Listen and learn!

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
  • 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 January 25, 2023

Leave a Reply

Your email address will not be published. Required fields are marked *

%d bloggers like this: