Emergent management of acute asthma

Asthma is defined as reversible airflow obstruction caused by bronchospasm and airway inflammation. When an acute exacerbation occurs, the patient's symptoms worsen significantly to warrant a visit to the emergency department, and occasionally hospitalization is needed to control symptoms. Status asthmaticus is defined as a severe episode of asthma unrelieved by usually effective bronchodilators drugs. Potentially fatal asthma (PFA) is ascribed to those patients listed in Table 1.(22) Malignant PFA delineates a subset of patients with PFA, whose noncompliance with management makes their disease virtually impossible to control.(11) Sudden asphyxic asthma refers to those patients that develop a sudden dramatic deterioration leading to respiratory failure over a few hours. Potentially avoidable factors are identified in up to 82% of all deaths from asthma that were evaluated in a study by the British Thoracic Association in 1979.(5)