Emergency Department Management of Pediatric Acute Asthma: An Evidence-Based Review (Pharmacology CME)

Points & Pearls Excerpt

• Not every patient who wheezes has asthma. Consider other etiologies such as pneumonia, foreign body aspiration, anaphylaxis, and congestive heart failure.⁵ (See Table 1.)
• Routine use of blood gases is no longer recommended. Use of pulse oximetry and end-tidal CO₂ are much more reliable and less invasive.⁴²
• Radiography is no longer routinely recommended for first-time wheezers, but chest x-rays should be considered in patients who have suspected pneumonia, pneumothorax, or foreign body aspiration.⁴⁴
• First-line therapy for pediatric acute asthma includes inhaled bronchodilators and corticosteroids in the first hour of ED stay.⁶²