II. Risk Factors: Fatal Asthma attack

III. Classification: Asthma Exacerbation Severity

  1. See Asthma Exacerbation Severity Evaluation
  2. Mild Asthma Exacerbation
    1. Dyspnea on exertion (or Tachypnea in young children)
    2. Peak Expiratory Flow (PEF) >70% of predicted
    3. Prompt relief with inhaled Short-acting Beta Agonists
    4. Home management
  3. Moderate Asthma Exacerbation
    1. Dyspnea limits usual activity
    2. Peak Expiratory Flow (PEF) 40-69% of predicted
    3. Relief with frequent inhaled Short-acting Beta Agonists
    4. Office management
      1. Add oral Systemic Corticosteroids
      2. Anticipate 1-2 days of symptoms after treatment onset
  4. Severe Asthma Exacerbation
    1. Dyspnea at rest, limiting conversation
    2. Peak Expiratory Flow (PEF) <40% of predicted
    3. Only partial relief with inhaled Short-acting Beta Agonists
    4. Emergency department management
      1. Hospitalization is likely
      2. Add Systemic Corticosteroids and ipratroprium
      3. Anticipte >3 days of some symptoms
  5. Life Threatening Asthma Exacerbation
    1. Unable to speak, severe Dyspnea with associated diaphoresis
    2. Peak Expiratory Flow (PEF) <25% of predicted
    3. Minimal relief with inhaled Short-acting Beta Agonists
    4. Emergency department stabilization
      1. Intensive care unit admission
      2. Frequent or continuous Albuterol nebs
      3. Add Systemic Corticosteroids and ipratroprium
      4. ABC Management

IV. Management

  1. See Asthma Exacerbation Home Management
  2. See Emergency Management of Asthma Exacerbation
    1. Asthma presenting to clinic with Oxygen Saturation at or below 90% may be best managed in emergency department
  3. See Asthma Inpatient Management
  4. See Status Asthmaticus

V. References

  1. (2007) Guidelines for the diagnosis and management of Asthma, NHLBI

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Ontology: Exacerbation of asthma (C0349790)

Concepts Finding (T033)
SnomedCT 195978009, 367110001, 281239006
Dutch exacerbatie van astma
German Exazerbation des Asthmas
Italian Esacerbazione di asma
Portuguese Exacerbação de asma
Spanish Exacerbación de asma, exacerbación de asma (trastorno), exacerbación de asma
Japanese 喘息増悪, ゼンソクゾウアク
French Exacerbation de l'asthme
English asthma with acute exacerbation, asthma with acute exacerbation (diagnosis), asthma exacerbation, exacerbation of asthma, acute exacerbation of asthma, acute asthma exacerbation, exacerbation asthma, of asthma exacerbation, asthma exacerbations, Exacerbation of asthma, Acute exacerbation of asthma, Exacerbation of asthma (disorder)
Czech Exacerbace astmatu
Hungarian Asthma exacerbatiója