Emergency Medicine Cases Ep 193 The Crashing Asthmatic – Recognition and Management of Life Threatening Asthma
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Apr 2, 2024 Experts Dr. Sameer Mal and Dr. Leeor Sommer discuss key elements in recognizing and managing life-threatening asthma, interventions like magnesium sulfate and epinephrine, NIPPV role, indications for intubation, ventilation strategies, and more in the emergency department.
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Avoid Benzodiazepines in Asthma
- Avoid benzodiazepines in asthma exacerbations, as they may increase mortality.
- Treat the respiratory problem first, then address the resulting anxiety.
Fentanyl for Severe Asthma
- Consider fentanyl in severe asthma to lower respiratory rate and break the anxiety-tachypnea cycle.
- Give 1-2 mcg/kg initially, allowing other medications time to work.
IV Salbutamol for Severe Asthma
- In severe asthma, consider IV salbutamol, especially when coordinating nebulizers with NIV is difficult.
- Start with 2-5 mcg/min, titrating up to 20 mcg/min, monitoring for tachycardia and hypertension.