Asthma is the most common chronic disease of childhood. Although home action plans and the use of maintenance medications have improved daily management and control of asthma, many children still require emergency department care at least once per year. Emergency clinicians must be able to manage patients with acute asthma exacerbations and determine their safe disposition. This issue reviews the current evidence-based emergency department management recommendations for moderate to severe acute asthma in pediatric patients. Timely use of bronchodilators and systemic corticosteroids, as well as adjunct modalities, are discussed. Current challenges in asthma management related to vaping and COVID-19 are also addressed.
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Following are the most informative references cited in this paper, as determined by the authors.
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Keywords: asthma, pediatric asthma, acute asthma, asthma exacerbation, asthma flare, status asthmaticus, wheezing, asthma scoring scales, bronchoconstriction, bronchodilator, increased work of breathing, respiratory distress, stridor, recurrent wheezing, cough-variant asthma, silent chest, short-acting beta-agonists, SABA, albuterol, anticholinergic, ipratropium, corticosteroid, dexamethasone, nebulizer, metered-dose inhaler, MDI, Pediatric Respiratory Assessment Measure, PRAM, Pediatric Asthma Severity Score, PASS, pulmonary index, PI, magnesium sulfate, ketamine, heliox, noninvasive ventilation, conventional oxygen therapy, high-flow nasal cannula, noninvasive positive-pressure ventilation, invasive ventilation, tracheal intubation, invasive mechanical ventilation, IMV, vaping, e-cigarettes, COVID-19
Audrey Zelicof Paul, MD, PhD, FAAP; Kim A. Rutherford, MD; Stephanie M. Abuso, DO
Donna J. Lee, MD; Joanna Schwartz, MD, FAAP
July 1, 2023
July 1, 2026   CME Information
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-B Credits. Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 2 Pharmacology CME credit, subject to your state and institutional approval.