title: [Management of severe acute asthma in adults].
abstract: Any life-threatening episode of asthma requires early pre-hospital specialized medical management by emergency medical crews. Gravity depends on both clinical criteria and a peak expiratory flow rate (PEFR) more than 30% below either the level predicted by the reference graph or the patient's reference value. Initial treatment combines continuous nebulizations containing a beta2-agonist and ipratropium bromide, with oxygen administration and intravenous corticosteroid bolus. Recommended as second-line treatment in the absence of adequate response are: intravenous magnesium sulphate and continuous-perfusion beta2-agonists (electric syringe), or, in the case of shock, epinephrine. If mechanical ventilation is required, its settings should aim for low tidal volumes, low frequency, and increased expiratory time.
authors.affiliation: Service Samu 11 - Smurs - SAU - Cesu 11, Centre Hospitalier Antoine Gayraud, Carcassonne. joye.fred@wanadoo.fr
authors.forename: F
authors.initials: F
authors.lastname: Joye
authors.forename: F
authors.initials: F
authors.lastname: Marion
authors.forename: C
authors.initials: C
authors.lastname: Broche
authors.forename: P
authors.initials: P
authors.lastname: Plaisance
authors.forename: S
authors.initials: S
authors.lastname: Guitteny
mesh_terms: D000208:Acute Disease; D000328:Adult; D000465:Algorithms; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D004630:Emergencies; D006801:Humans; D012307:Risk Factors