EMRA Simulation Guide

Pulmonary - Asthma Exacerbation

CASE: 67-year-old male presents with progressive SOB

Learning Objectives

1. Recognize when an adult has an immediate life-threatening condition
2. Manage a patient with impending respiratory distress
3. Create a broad differential for a patient with shortness of breath
4. Order appropriate studies in a short of breath patient
5. Recognize what imaging is most appropriate for the unstable patient

Critical Actions

• Establish large bore IV access
• Place patient on monitors with continuous oxygen saturation and vitals
• Place patient on continuous end-tidal CO2 monitoring
• Procure a detailed patient COPD history including previous intubations
• Ask for and interpret appropriate labs (e.g.CBC, blood gas, etc.)
• Request a CXR
• Administration of appropriate escalating interventions for severe COPD exacerbation
• Reassessment of patient’s pain and vital signs
• Appropriate consultations called
• Closed loop communication
• Synthesis of the case
• Disclose appropriate information to the patient/family

Download the case here.