What signs indicate an asthma attack in an ED-like environment and what may be done?

• A. Chest pain and fever; administer antibiotics.
• B. Wheezing, shortness of breath; assist with inhaler per protocol if allowed.
• C. Severe hypertension; administer diuretics.
• D. Hypotension with bradycardia; perform immediate intubation.

Answer: (B)

An asthma attack in an ED setting is identified by respiratory distress with bronchospasm, most clearly wheezing and shortness of breath. The priority is rapid bronchodilation to reverse airway narrowing, so the best action is to assist with a fast-acting inhaler (or deliver via nebulizer) per your local protocol, along with oxygen if needed to maintain adequate saturation. After administering the bronchodilator, continuously reassess the patient’s breathing, allow additional doses as permitted, and consider systemic steroids to reduce airway inflammation. The aim is quick relief of symptoms and prevention of deterioration, with escalation to more advanced airway support if the patient shows signs of fatigue, rising work of breathing, or declining oxygen levels.

Other sketches of symptoms point to different emergencies: chest pain with fever suggests infection or cardiac issues; severe hypertension with diuretics targets blood pressure, not bronchospasm; hypotension with bradycardia requiring immediate intubation indicates impending or established airway failure rather than an initial asthma presentation.