Management of asthma in adults. National Asthma Education and Prevention Program.

Additional bronchodilator treatments (eight puffs each of salbutamol and ipratropium through a metered-dose inhaler with a valved holding chamber) are administered, along with 2 g of magnesium sulphate, given intravenously over 20 minutes.

There is strong evidence to support the role of action plans detailing how to prevent and manage future exacerbations.

Rodrigo GJ, Assessing symptoms and peak expiratory flow rate as predictors of asthma exacerbations [published correction appears in National Heart Lung and Blood Institute.

Hypoxia is the main cause of death in cases of acute asthma. It is essential to teach patients how to monitor signs and symptoms, and take appropriate action. Camargo CA Jr, Spooner CH, Rowe BH. Rowe BH. Rowe B, Kilburn S,

Aaron SD, )Algorithm for home management of acute asthma exacerbations. Sloots TP,

Clark R,

Coates A. Rowe BH. McFadden ER. Expert panel report 3: Guidelines for the diagnosis and management of asthma; 2007:377. Intravenous versus oral corticosteroids in the management of acute asthma in children. The National Asthma Education and Prevention Program's “Expert Panel 3 Report: Guidelines for the Diagnosis and Management of Asthma” section on management of asthma exacerbations was reviewed. (PEF = peak expiratory flow. 4. Gøtzsche PC, In patients with a peak expiratory flow of 50 to 79 percent of their personal best, up to two treatments of two to six inhalations of short-acting betaIn 2005, the prevalence of asthma in the United States was nearly 8 percent (close to 9 percent in children younger than 18 years), and approximately 4 percent of Americans (5 percent of children) experienced an asthma attack.One study of children up to 18 years of age presenting to the emergency department with acute asthma symptoms identified multiple risk factors for a subsequent emergency department visit: age younger than two years, black race or Hispanic ethnicity, persistent asthma, public health insurance, lower asthma quality-of-life scores, and increased use of the health care system during the previous 12 months.In persons older than two years with asthma, neither the injectable nor the intranasal influenza vaccine increases the likelihood of an asthma exacerbation in the period immediately following vaccination.

For information about the SORT evidence rating system, go to Adapted from the National Heart Lung and Blood Institute. Because exacerbations vary in severity, close communication between patients and physicians is required.

Several studies have demonstrated that the use of structured care plans and observation units is associated with reduced rates of hospital admission and reduced lengths of stay. Rowe BH, Parameswaran K, Belda J, Rowe BH. Spooner C,

Quon BS,

We do not capture any email address.All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.British Thoracic Society; Scottish Intercollegiate Guidelines Network. Roesner JF,

Rachelefsky G, Edmonds ML, In patients with a peak expiratory flow of 50 to 79 percent of their personal best, up to two treatments of two to six inhalations of short-acting beta2 agonists 20 minutes apart followed by a reassessm… Available: Cates CJ, Crilly JA, Rowe BH.

à. p.99 p.99.

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Bretzlaff JA, Pestian J, Asthma prevalence, health care use and mortality: United States, 2003–05. Stephens D, Combined inhaled anticholinergics and betaQureshi F, Wedzicha JA.

Control of asthma by aerosols. Price D, Expert panel report 3: Guidelines for the diagnosis and management of asthma; 2007:382. For more details.

Manser R, Reid D, Abramson MJ. Travers A,

Bota GW. Qureshi F,

Adapted from the National Heart Lung and Blood Institute. Parent initiated prednisolone for acute asthma in children of school age: randomised controlled crossover trial.

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