Episode 66 - Acute Asthma

Episode 66 – Acute Asthma Exacerbations – An Interview with Dr. Steven Hochman and Dr. Brandon SomwaruEMplify – February 2022Emergency Department Management of Acute Asthma ExacerbationsInterview with the authors: Steven M. Hochman, MD, and Brandon Somwaru, DO Episode Outline:EpidemiologyRisk factors for death from asthma (Table 1)Triggers for asthma attacksVariants of asthma (Table 2)Differential diagnosis (Table 3)Can PE be a trigger for an acute asthma attack? Prehospital careED care: history (what should we ask?)ED care: physical exam (what are we looking for?)Classifying mild/moderate/severe asthma Lab studiesPOCUS (Table 5 and Figure 3)Peak expiratory flowETCO2 capnography and capnometryChest x-rayTreatment (Table 6)MedicationsOxygenSABA vs LABAWhat about MDIs?Continuous nebs?AnticholinergicsSteroids (IV, oral, inhaled; prednisone vs dexamethasone)Magnesium sulfateEpinephrineTerbutalineKetamineNIPPVIntubation pearls and pitfalls (Table 8)Special populationsPediatrics PregnancyCOVID-19 Controversies and cutting edgeBiologicsFractional exhaled nitric oxideHeliox High flow nasal cannulaDelayed sequence intubationECMODisposition