Episode 66 - Acute Asthma

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 (https://www.ebmedicine.net/topics/air...) 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