Acute Asthma

Author: Gary T Kitching, Jason B Lee / Editor: Jason M Kendall / Reviewer: Michael Perry, Jon Bailey / Code: / Published: 29/04/2021

After completing this session you will be able to:

• Describe the patho-physiology of asthma
• Categorise the severity of an asthma attack
• Identify life-threatening features of an asthma attack
• Employ appropriate treatments according to the severity of attack
• Differentiate those patients that require admission from those that can be discharged from the emergency department

Supplementary BTS Guidance on Asthma during the Covid-19 pandemic

References:

1. Hospital Episode Statistics, 2006-2007. Department of Health.
2. British Thoracic Society/ SIGN Guidelines for the Management of Asthma 2011 Guidelines. May 2008 (revised May 2011). www.brit-thoracic.org.uk
3. Busse WW, Calhoun WF, Sedgwick JD. Mechanism of airway inflammation in asthma. Am Rev Respir Dis. Jun 1993;147(6 Pt 2):S20-24.
4. Blanc PD, Toren K. How much adult asthma can be attributed to occupational factors? Am.J.Med.1999;107(6):580-587.
5. Harrison BDW, Slack R, Berrill WT, et al. Results of a national confidential enquiry into asthma deaths. Asthma J. 2000;5(4);180-186.
6. Pearson MG, Spence DP, Ryland I, et al. Value of assessing pulsus paradox in assessing acute severe asthma. BMJ 1993;307(6905):659.
7. Robinson SR, Harrison BD, Lambert MA. Effect of a pre-printed form on the management of acute asthma in an accident and emergency department. J Accid Emerg Med. 1996;13(2):93-97.
8. Rowe BH, Spooner C, Ducharme FM, et al. Early emergency department treatment of acute asthma with systemic corticosteroids. The Cochrane Library 2001;Issue3.
9. Starobin D, Bolotinsky L, Or J, et al. Efficacy of nebulized fluticasone propionate in adult patients admitted to the emergency department due to bronchial asthma attack. Isr Med Assoc J. 2008;10(8-9):568-571.
10. Soroksky A, Stav D, Shpirer I. A Pilot Prospective, Randomized, Placebo Controlled Trial of Bilevel Positive Airway Pressure in Acute Asthmatic Attack. Chest 2003;123:1018-1025.
11. Lichtenstein DA. Lung Ultrasound in the Critically Ill. Ann Intensive Care 2014. PMID: 24401163
12. Lichtenstein DA et al. A Bedside Ultrasound Sign Ruling Out Pneumothorax in the Critically Ill. Lung Sliding. Chest 1995. PMID: 7587439
13. Lichtenstein D et al. The “Lung Point”: An Ultrasound Sign Specific to Pneumothorax. Intensive Care Med 2000. PMID: 11126253
14. Lichtenstein DA et al. Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure: The BLUE Protocol. Chest 2008. PMID: 18403664

Further Reading

• British Thoracic Society/Scottish Intercollegiate Guideline Network: British Guideline on the Management of Asthma. 2011 Guideline. brit-thoracic.org.uk