II. Precaution

  1. One third of fatal Asthma attacks occur in children with only Mild Asthma history
  2. Emphasize Asthma Education and Asthma Action Plan at each visit
  3. One or more risk factors should prompt early and aggressive evaluation for Asthma Exacerbations
    1. Have low threshold for hospitalization of Asthma Exacerbation
    2. Consider Intensive Care unit admission

III. Risk Factors: Asthma History predisposing to Asthma-related death

  1. Patient unable to sense or distinguish Severe Asthma attack
  2. Prior serious Asthma Exacerbation with ICU admission, loss of consciousness, Respiratory Failure or intubation
  3. Prior Asthma complications with hypercapnia, Metabolic Acidosis or Pneumothorax
  4. Two hospitalizations or three emergency department visits in the last year
  5. Hospitalization or emergency department visit in the last month
  6. At least two refills of short acting beta Agonist (e.g. Albuterol) per month
  7. Severe Asthma attacks despite longterm systemic, oral Corticosteroids

IV. Risk Factors: Social History predisposing to Asthma-related death

  1. Illicit Drug use
  2. Low socioeconomic status
  3. Inner city residence

V. Risk Factors: Comorbidity predisposing to Asthma-related death

  1. Underlying cardiopulmonary disease (CAD, CHF, COPD)
  2. Serious mental health disorders

VI. Resources

  1. Guidelines for the Diagnosis and Management of Asthma (EPR-3)
    1. https://www.nhlbi.nih.gov/guidelines/asthma/

VII. References

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