Ep 192 ED Adult Asthma Management Strategies For Improved Prognosis – A Stepwise Approach

Emergency Medicine Cases

Dr. Anton Helman

Education, Health & Fitness, Courses, Medicine, Science

4.7 • 602 Ratings

🗓️ 19 March 2024

⏱️ 54 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this part 1 of our 2-part podcast series on Asthma Management we explore a systematic approach to managing patients presenting to the ED with asthma exacerbations. Our discussion will emphasize the critical role of a thorough history and physical examination in effectively stratifying patient risk and guiding treatment/disposition decisions. Additionally, we'll examine the importance of providing comprehensive discharge medications and instructions to mitigate both mortality and morbidity associated with asthma exacerbations. We answer questions such as: which patients, if any, require peak expiratory flow measurements in the ED? Why is it so important to add steroid MDI therapy to oral steroid therapy in patients being discharged from the ED after an asthma exacerbation? What are the most predictive variables to risk stratify patients with asthma exacerbations to help guide treatment and disposition? and many more. Stay tuned for Part 2, where we'll delve deep into the management of the crashing asthmatic. Please support EM Cases FOAMed with a donation: https://emergencymedicinecases.com/donation/

Transcript

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0:00.0	Welcome to the Emergency Medicine Cases podcast.
0:05.0	I'm your host, Dr. Anton Hellman, bringing you Canada's brightest minds in emergency medicine from EMC studios in Toronto.
0:13.9	EM cases is part of SREMI, Schwartz-Risman Emergency Medicine Institute, the nonprofit organization dedicated to improving EM care through research
0:21.1	and education. The opinions expressed on this podcast are intended for information and education
0:24.3	purposes only and should not be used to diagnose treat or prevent any medical condition,
0:26.4	nor should they be used as a substitute for medical advice from qualified practicing physician.
0:30.3	This episode is brought to you by Easy Recess, the Resuscitation Assistant. This amazing app has
0:35.5	drug dosing, equipment size calculation, treatment algorithms,
0:38.5	all in under three clicks. Rapid access to life-saving critical info in a user-friendly interface.
0:45.4	Try the app for free with the promo code EMCases or visit easy recess.com slash EMCases.
0:53.1	That's easy recess.com slash EMC-A-'s easy recess.com slash EMCASES. This past summer, it became quite
1:01.0	apparent that forest fires were becoming a problem. One of the consequences of the forest fires
1:07.1	was more air pollution. And it turns out that the incidence of asthma is quite a bit
1:12.1	higher if the air in your neighborhood is more polluted. So the more nitrogen dioxide and carbon
1:18.4	monoxide in the air, the more asthma. In fact, a recent study out of Calgary in Canada suggested
1:24.2	that there were 13% more asthma exacerbations presenting to EDs when there was
1:29.7	visible wildfire smoke in the city. Anyway, we're seeing more asthma in EDs, and unfortunately
1:36.7	there are still a lot of totally preventable deaths from asthma. I think we can do better
1:42.8	rest ratifying and managing these patients. So, I asked a friend
1:46.5	and colleague of mine, Master Clinician ED Doc at North York General Hospital in Toronto, Dr. Lear
1:51.2	Summer, to update us on the state of the art of ED management of asthma. Welcome back, Dr. Summer.
1:59.4	Thank you so much for having me again.
	...

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