II. Precaution
- One third of fatal Asthma attacks occur in children with only Mild Asthma history
- Emphasize Asthma Education and Asthma Action Plan at each visit
- One or more risk factors should prompt early and aggressive evaluation for Asthma Exacerbations
- Have low threshold for hospitalization of Asthma Exacerbation
- Consider Intensive Care unit admission
III. Risk Factors: Asthma History predisposing to Asthma-related death
- Patient unable to sense or distinguish Severe Asthma attack
- Prior serious Asthma Exacerbation with ICU admission, loss of consciousness, Respiratory Failure or intubation
- Prior Asthma complications with hypercapnia, Metabolic Acidosis or Pneumothorax
- Two hospitalizations or three emergency department visits in the last year
- Hospitalization or emergency department visit in the last month
- At least two refills of short acting beta Agonist (e.g. Albuterol) per month
- Severe Asthma attacks despite longterm systemic, oral Corticosteroids
IV. Risk Factors: Social History predisposing to Asthma-related death
- Illicit Drug use
- Low socioeconomic status
- Inner city residence
V. Risk Factors: Comorbidity predisposing to Asthma-related death
- Underlying cardiopulmonary disease (CAD, CHF, COPD)
- Serious mental health disorders
VI. Resources
- Guidelines for the Diagnosis and Management of Asthma (EPR-3)