Asthma symptoms and reduced flow rates that are unresponsive
to initial therapy are defined as status asthmaticus. This patient has a
severe exacerbation characterized by elevated pulsus paradoxus, use of
accessory muscles, and peak expiratory flows (PEFs) less than 50 of
predicted, with no improvement after inhalation of bronchodilators.
With minimal airflow, wheezes may not be heard. This patient should
be urgently admitted to the hospital. An arterial blood gas measurement
should be obtained to evaluate for hypercarbic respiratory failure.
Antibiotics are not indicated for exacerbations of asthma, unless a
specific infection is identified.
- Admit the patient to the hospital with a diagnosis of status
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Hospital Physician Board Review Manuals
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