If symptoms resolve
Often, patients will still have mild wheezing, but should have complete resolution of tachypnea, hypoxia, and work of breathing if being discharged
A short course of glucocorticoids decreases chance of relapse - prednisone in adults (40-60 mg/day for 5-10 days without tapering) or dexamethasone (0.6mg/kg) in children
Often, patients will still have mild wheezing, but should have complete resolution of tachypnea, hypoxia, and work of breathing if being discharged
A short course of glucocorticoids decreases chance of relapse - prednisone in adults (40-60 mg/day for 5-10 days without tapering) or dexamethasone (0.6mg/kg) in children
If symptoms persist or are severe
Classically disposition is based on peak flow measurements - however, these measurements are often not available in the ED
Predicted = (30 x age (yrs)) + 30
PEF >70% predicted → high likelihood of successful discharge
PEF <40% predicted → should be admitted
Predicted = (30 x age (yrs)) + 30
PEF >70% predicted → high likelihood of successful discharge
PEF <40% predicted → should be admitted
Acute asthma exacerbation
Pulmonary
COPD exacerbation
Airway obstruction
Acute chest syndrome
Anaphylaxis
Acute dyspnea
Angioedema