[Management of asthma attacks in primary care practice].
Most fatal asthma attacks are explained by an underestimation of the severity of the episode and by an underutilization of adequate treatments. The primary care physician should: 1) identify predictors of poor outcome requiring immediate hospital admission, 2) evaluate the severity of the attack, using clinical criteria and peak-flow measurements, and 3) initiate a treatment combining inhaled beta2-agonists and oral steroids. Life threatening asthma attacks warrant immediate hospitalisation as well as severe attacks persisting after initial treatment. Moderate attacks don't usually require referral. Other factors, such as social factors, compliance to treatment, or co-morbid conditions, may warrant hospitalisation.
Rutschmann
O
O
Département de médecine interne, Service de médecine interne générale, Unité de médecine interne d'accueil et d'urgences, HUG, 1211 Genève 14. olivier.rutschmann@hcuge.ch
Janssens
J P
JP
D000208:Acute Disease; D000280:Administration, Inhalation; D000284:Administration, Oral; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000465:Algorithms; D001249:Asthma / Q000188:drug therapy* / Q000473:pathology; D015897:Comorbidity; D006760:Hospitalization; D006801:Humans; D011320:Primary Health Care; D012720:Severity of Illness Index; D013256:Steroids / Q000008:administration & dosage / Q000627:therapeutic use*
D000318:Adrenergic beta-Agonists; D013256:Steroids