Asthma Exacerbation- Risk Factors, Triggers, Symptoms

Question 1

Asthma exacerbation definition

Answer 1

A progressive increase in SOB, cough, wheezing, or chest tightness and progressive decrease in lung function

Question 2

Asthma exacerbation triggers

Answer 2

Viral respiratory infections
Allergens (pollen, fungal)
Food allergy
Air pollution
Seasonal changes
Poor adherence to ICS

Question 3

Factors that increase asthma-related death

Answer 3

Hx of asthma requiring intubation and mechanical ventilation

Hospitalization or ED visit within 1 year

Currently using (or recently stopped using) PO corticosteroids

Not currently using ICS

Overuse of a SABA: >1 albuterol/month

PMH/SH of psychiatric or psychosocial problems,

food allergies

Poor adherence with ICS asthma medications or written asthma action plan

Comorbidities: pneumonia, DM, arrhythmias after hospitalization for an asthma exacerbation

Question 4

Mild-moderate asthma exacerbation symptoms

Answer 4

Talks in phrases

Prefers sitting to lying

Not agitated

Respiratory rate increased

No accessory muscle use

Pulse rate 100-120 bpm

O2 sat on air is 90-95%

PEF >50% predicted or best

Question 5

Severe asthma exacerbation symptoms

Answer 5

Talks in words

Sits hunched forwards

Agitated

Respiratory rate >30/min

Accessory muscle use

Pulse rate >120bpm

O2 saturation on air <90%

PEF ≤50% predicted or best

Question 6

Where can mild-moderate asthma exacerbations be treated?

Answer 6

Outpatient/primary care

Question 7

Where can severe asthma exacerbations be treated?

Answer 7

ED or patient gets admitted to the hospital

Question 8

Asthma exacerbation treatment goals

Answer 8

Correct hypoxemia (if present)

Reverse obstruction

Decrease relapse