Emergency Management of Asthma Exacerbations

Asthma is a complex airway disorder affecting an estimated 32.6 million Americans sometime within their lifetime, and costing the healthcare system an estimated $19.7 billion annually (American Lung Association (ALA), 2007). Allergens and irritants trigger exacerbations, leading to an inflammatory cascade that results in airway obstruction. This disease process is both a chronic life-altering and a potential life-threatening condition impacting both the patient and the family. It is essential for practitioners to be informed, educated, and updated on the most recent guidelines and recommendations for the treatment of asthma exacerbations. In 1989, the first National Asthma Education and Prevention Program (NAEPP) Expert Panel Report (EPR) was convened to develop guidelines for the diagnosis and management of asthma on the basis of current research (NAEPP, 1989). An update on these guidelines is the third NAEPP EPR (EPR-3), which was released last year (NAEPP, 2007). This article examines the pathophysiology and epidemiology of asthma and the presentation, differential diagnoses, diagnostic tests, and treatment modalities as proposed by the 2007 NAEPP EPR-3.