Status asthmaticus. From the emergency department to the intensive care unit

• Published in: Clinical reviews in allergy & immunology Vol. 20; no. 3; pp. 271 - 292
• Main Authors: Kenyon, N, Albertson, T E
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.06.2001
• Subjects: Adrenergic beta-Agonists - therapeutic use; Adult; Blood Gas Analysis; Bronchodilator Agents - therapeutic use; Cholinergic Antagonists - therapeutic use; Emergency Medical Services; Forced Expiratory Volume - physiology; Glucocorticoids - therapeutic use; Humans; Intensive Care Units; Intubation; Mortality; Oxygen - therapeutic use; Peak Expiratory Flow Rate - physiology; Radiography; Respiration, Artificial; Status Asthmaticus - diagnostic imaging; Status Asthmaticus - physiopathology; Status Asthmaticus - therapy; Theophylline - therapeutic use; United States - epidemiology
• ISSN: 1080-0549; 1559-0267; 1080-0549
• DOI: 10.1385/CRIAI:20:3:271

SA patients represent the most critical and challenging of all asthmatics. SA is a medical emergency that requires timely evaluation and initiation of therapy by pre-hospital and ED staff. Morbidity and mortality of patients who progress to respiratory failure requiring intubation and ventilator support remains significant. Debate whether SA represents a separate pathophysiologic entity in the spectrum of asthma is likely to continue until further understanding of this disease is gained. Until that time, therapy in the ED will center on β-agonists, bronchodilators, parenteral steroids, consideration of adjunctive treatments, and critical airway skills in those requiring assisted ventilation. Appropriate coordinated care between the ED and the ICU team is important to prevent unnecessary errors in the triage or lapses in care. Though SA patients are critically ill, well-orchestrated care can be wholly satisfying for the patient and the treating team of physicians, nurses, and respiratory therapists.[PUBLICATION ABSTRACT]