Approach to the Critical Patient

Immediate priorities

Airway and ventilation threats

Hemodynamic threats

Initial stabilization

Oxygen and monitoring

Immediate bronchodilator and corticosteroid initiation

Escalation triggers

Criteria for escalation to resuscitation bay

Intubation decision

History

Presentation pattern

Core symptoms

Duration and onset

Risk factors for severe exacerbation

Prior asthma severity markers

Medication factors

Psychosocial and demographic risk factors

Triggers

Common precipitants

Prior asthma history

Disease control baseline

Physical Exam

Vital signs

Severity snapshot from vitals

Respiratory exam

Auscultation findings

Accessory muscle use

General appearance

Mental status and appearance

Signs suggesting alternative diagnoses

PITFALLS

Exam interpretation pitfalls

Differential Diagnosis

Life-threatening mimics

Urgent alternative diagnoses

Near-life-threatening presentations

Common mimics

Respiratory tract conditions

Other conditions

Laboratory Tests

Core labs

Blood count and metabolic panel

Arterial blood gas

ABG interpretation in status asthmaticus

Adjunct testing

Cardiac biomarkers and ECG

Sputum and infection markers

Diagnostic Tests

Scoring Systems

Asthma severity classification

Pulmonary function targets

MRI

MRI role in status asthmaticus

CT

CT chest indications in status asthmaticus

Ultrasound

Point-of-care ultrasound role

Disposition

Criteria for admission

Hospital admission indications

ICU admission indications

Discharge criteria

Safe discharge requirements

Transfer criteria

Treatment

Inhaled bronchodilators

Short-acting beta-2 agonist

Systemic corticosteroids

Corticosteroid dosing

Magnesium sulfate

IV magnesium sulfate

Epinephrine and systemic beta-agonists

Epinephrine indications

Refractory and rescue therapies

Ketamine

Heliox

Inhaled anesthetics

Mechanical ventilation strategy

Ventilator settings for intubated asthmatic

Sedation and paralysis

Noninvasive ventilation

HFNC and NIV considerations

Special Populations

Pregnancy

Asthma in pregnancy

Geriatric

Older adult considerations

Pediatrics

Pediatric asthma considerations

Background

Epidemiology

Burden of disease

Pathophysiology

Mechanisms of airflow obstruction

Ventilatory failure mechanism

Therapeutic Considerations

Bronchodilator evidence base

Corticosteroid evidence

Preventing intubation

Patient Discharge Instructions

copy discharge instructions

Status asthmaticus home care instructions

Warning signs requiring immediate return to the ER

Follow-up instructions

Prevention tips

References

Guidelines and key sources

Primary guidelines

Key reviews and emergency medicine sources

Pharmacology and refractory management

Coding standards

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.