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• W3012233859 endingPage "451" @default.
• W3012233859 startingPage "441" @default.
• W3012233859 abstract "Asthma is a common reason for presentation to the Emergency Department and is associated with significant morbidity and mortality. While patients may have a relatively benign course, there is a subset of patients who present in a critical state and require emergent management. This narrative review provides evidence-based recommendations for the assessment and management of patients with severe asthma. It is important to consider a broad differential diagnosis for the cause and potential mimics of asthma exacerbation. Once the diagnosis is determined, the majority of the assessment is based upon the clinical examination. First line therapies for severe exacerbations include inhaled short-acting beta agonists, inhaled anticholinergics, intravenous steroids, and magnesium. Additional therapies for refractory cases include parenteral epinephrine or terbutaline, helium‑oxygen mixture, and consideration of ketamine. Intravenous fluids should be administered, as many of these patients are dehydrated and at risk for hypotension if they receive positive pressure ventilatory support. Noninvasive positive pressure ventilation may prevent the need for endotracheal intubation. If mechanical ventilation is required, it is important to avoid breath stacking by setting a low respiratory rate and allowing permissive hypercapnia. Patients with severe asthma exacerbations will require intensive care unit admission. This review provides evidence-based recommendations for the assessment and management of severe asthma with a focus on the emergency clinician." @default.
• W3012233859 created "2020-03-23" @default.
• W3012233859 creator A5018567151 @default.
• W3012233859 creator A5035503211 @default.
• W3012233859 creator A5036463797 @default.
• W3012233859 creator A5091612725 @default.
• W3012233859 date "2021-06-01" @default.
• W3012233859 modified "2023-10-16" @default.
• W3012233859 title "Evaluation and management of the critically ill adult asthmatic in the emergency department setting" @default.
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