Emergency Treatment for Asthma Exacerbation

Severe asthma can be life threatening, in particular because of potentially rapid deterioration. A doctor's office can administer short-acting beta-agonists and oxygen, but serious asthma requires observation and monitoring.

Assessment

• Initial assessment in the emergency room helps the doctor guide the course of treatment. Functional assessment determines how well the patient is breathing. A history determines onset, cause, severity of symptoms related to previous exacerbations and current medications. Physical assessment identifies potential complications and rules out airway obstruction. Lab studies identify related conditions or toxicity.

Initial Treatment

• Initial treatment for asthma exacerbation includes oxygen and short-acting beta-agonists. Typically, doctors administer three short-acting beta-agonist treatments, 20 to 30 minutes apart. Doctors also treat moderate-to-severe or prolonged exacerbations with oral corticosteroids.

Excluded Treatment

• Treatments typically excluded for emergency asthma care include methylxanthines, aggressive hydration, chest physical therapy, mucolytics and sedation. These treatments may initially seem to be warranted for asthma exacerbation, but actually can worsen symptoms or provide little incremental benefit to standard treatments of oxygen, beta-agoinsts and corticosteroids. Your doctor will only provide antibiotics if there is evidence of a bacterial infection, such as sinusitis.

Re-assessment

• Following the initial treatment, your doctor will re-assess your condition by measuring peak flow, oxygen saturation and symptoms. These results will determine the frequency and type of follow-up treatments.

Release or Hospitalization

• Following a period of treatment and assessment, the doctor will decide whether to release or hospitalize the patient. This decision will be made based on the duration and severity of symptoms, response to treatment and access to medical care.