The evaluation and management of acute, severe asthma

There are 1.8 million emergency department visits, 500,000 hospitalizations, and 5500 deaths yearly in the United States from acute asthma exacerbations. Favorable outcomes in acute, severe asthma can be maximized by using an organized approach to the patient that relies on a focused but thorough clinical assessment, prompt initiation of treatment, and modification of subsequent therapy based on the individual's initial response. A review of recent literature, information obtained from published national and international guidelines, and the authors' clinical experience form the basis for this article's approach to the management of patients with acute, severe asthma.