Emergency department management of acute asthma exacerbations.

Asthma is a disease of the airways characterized by inflammation, hyperresponsiveness, and bronchoconstriction. The diagnosis is primarily a clinical one, based on a focused history and physical examination, to differentiate from other entities such as heart failure, pneumonia, and pulmonary embolism. Radiographs, laboratory studies, and blood gases are not routinely recommended, except in atypical or refractory cases, or if there is diagnostic uncertainty. The cornerstone of acute asthma treatment includes short-acting beta agonists, anticholinergics, and systemic corticosteroids. This issue reviews the latest evidence in diagnostic and treatment strategies, including other pharmacologic treatments and newer management strategies to avoid intubation.