CHEST 2023 On Demand Pass-Status Asthmaticus From the ED to the ICU: A Choose Your Own Adventure Case-Based Review

Status Asthmaticus From the ED to the ICU: A Choose Your Own Adventure Case-Based Review

Video Transcription

Video Summary

In this video transcript, a case of a young patient with severe asthma exacerbation is discussed. The patient presents to the emergency department with worsening symptoms despite using their asthma emergency plan. Initial management includes oxygen therapy and nebulizers. The next steps are determined through a team discussion using colored cards. The options include risk stratifying the patient, starting steroids, or giving more oxygen. The majority of the team chooses to start the patient on nebulizers. The patient's condition continues to deteriorate and they are intubated. The team then discusses ventilator settings, including respiratory rate, tidal volume, and PEEP. Sedation is also discussed and propofol and ketamine are mentioned as possible options. The team emphasizes the need for close monitoring and adjustment of settings as needed. Salvage therapies including diacuronium infusion and biologic therapy are also mentioned as potential options. The patient eventually improves and is extubated on day three. Overall, the case emphasizes the importance of early intervention, close monitoring, and individualized management in severe asthma exacerbations.

Meta Tag

Category Allergy and Airway

Session ID 1067

Speaker Alice Gallo De Moraes

Speaker Meredith Greer

Speaker Justin Rearick

Speaker David Shore

Track Allergy and Airway

Track Critical Care

Keywords

severe asthma exacerbation

emergency department

nebulizers

ventilator settings

sedation

close monitoring

salvage therapies

biologic therapy

individualized management