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Show Notes
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
- NIPPV
- 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