Asthma Exacerbation | Case Breakdown (August 23rd, 2024)

🚑🚨You're dispatched to an apartment complex for a 34-year-old female with respiratory distress.

Upon arrival, you find the patient sitting on the couch, in and out of a tripod position. She appears alert but is in obvious distress. She states she has “been using her inhaler all day, but it hasn’t been working.” The patient is anxious and refuses to lie back on the couch or stretcher.

Physical Exam:
CAOx4 but anxious
GCS: 15
CV: Tachycardic, bounding pulses, diaphoresis
RESP: Obvious distress with diffuse inspiratory and expiratory wheezing, overall poor air movement.

Your partner obtains the following vitals:
HR: 120
BP: 154/70
RR: 34
SpO2: 92% (room air)

The patient informs you that she has been admitted to the ICU multiple times for her asthma and intubated twice.

❓What’s your working diagnosis?
❓How do you want to manage this patient?

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