Emergency Department Management of Acute Asthma Exacerbations | Points & Pearls
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Emergency Department Management of Acute Asthma Exacerbations

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  • The differential diagnosis for dyspnea includes COPD, heart failure, pneumonia, pulmonary embolism, and pneumothorax. See Table 4 for a list of physical examination findings for each.
  • The National Asthma Education and Prevention Program2 classifies asthma exacerbations thus:
    • Mild: well-appearing, dyspnea with light activity, subtle wheezing; symptoms usually resolve with treatment at home.
    • Moderate: dyspnea inhibits activity, wheezing on exhalation, increased accessory muscle use, increased respiratory rate, tachycardia.
    • Severe: dyspnea at rest, inability to speak sentences, significant accessory muscle use, tachypnea, tachycardia, diaphoresis, agitation, and altered mental status. Wheezing may be loud. Absent wheezing indicates impending respiratory failure; intubation should not be delayed if it is deemed necessary.
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Publication Information
Authors

Steven M. Hochman, MD, FACEP; Anthony Catapano, DO, FACOEP; Arsalan Shawl, DO; Brandon Somwaru, DO

Peer Reviewed By

Drew Clare, MD; Gabriel Wardi, MD, MPH

Publication Date

February 1, 2022

CME Expiration Date

February 1, 2025

Pub Med ID: 35072366

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CME Information

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