Emergency Department Assessment

Paramount in the evaluation of AA is determination of attack severity and the risk of respiratory failure. Patients with AA at presentation to the ED or clinic are often in considerable visible distress. Dyspnea and wheezing are common elements in an asthma exacerbation. Among the myriad of other

Figure 1 U.S. national statistics on asthma prevalence and mortality show that consistent increases in both these values over the last three decades may have finally reached plateaus. Source: Adapted from Ref. 9.

attributable signs and symptoms, there is no uniformly consistent finding present in all cases. The key components of this assessment include history, physical examination, objective measurement of airflow limitation, and quantification of early response to initial therapy. Each of these components is independently informative in the complete evaluation of the AA patient (14).

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