Janet Boehm EdD, MS, RRT
Director, Clinical Education
Youngstown State University
Youngstown, OH

Richard Branson, MS, RRT, FAARC
Associate Professor of Surgery
University of Cincinnati College of Medicine Cincinnati, OH

Richard Kallet, MSc RRT, FAARC
Clinical Projects Manager
University of California
Cardiovascular Research Institute
San Francisco, CA

Donna Hamel, RRT, FAARC
Clinical Research Coordinator
Duke University Health Systems
Raleigh-Durham, NC

Neil MacIntyre, MD, FAARC
Medical Director of Respiratory Services
Duke University Medical Center
Durham, NC

Tim Myers, BS, RRT-NPS
Pediatric Respiratory Care
Rainbow Babies and Children’s Hospital
Cleveland, OH

Tim Op’t Holt, EdD, RRT, AEC, FAARC
Professor, Department of Respiratory Care
and Cardiopulmonary Sciences
University of Southern Alabama
Mobile, AL

Ruth Krueger Parkinson, MS, RRT
Protocol/ PI Coordinator
Sioux Valley Hospital
Sioux Valley, SD

Helen Sorenson, MA, RRT, FAARC
Assistant Professor, Dept. of Respiratory Care
University of Texas Health Sciences Center
San Antonio, TX

Asthma Exacerbations
Karen Gregory, MS, APRN-BC, RRT, AE-C
Asthma exacerbations are common in patients with uncontrolled asthma and carry a considerable burden of morbidity. Despite treatment guidelines by the National Asthma Education and Prevention Program (NAEPP) Expert Panel Report 3 (EPR-3) and the Global Initiative for Asthma (GINA), patients continue to experience uncontrolled asthma and thus are at increased risk for severe exacerbations. Asthma exacerbations can be caused by viral or bacterial infections, sinus disease, gastroesophageal reflux, and a host of other conditions. Genetic, prenatal and environmental factors all contribute to the risk of asthma and asthma exacerbations. Without proper management, asthma can lead to lung structural changes and permanent impairment. Effective control of asthma exacerbations starts with risk assessment to determine the appropriate treatments, and continues with patient education to ensure that treatment protocols are followed. The EPR-3 recommends a short-acting β-agonist as initial treatment for all patients, oxygen for most patients, with additional multiple doses of ipratropium bromide for patients who have severe exacerbations in the emergency department and systemic corticosteroids for most patients. Heliox-driven, nebulized albuterol is recommended for patients who have life-threatening exacerbations and for patients whose execration remains in the severe category after 1 hour of conventional treatment. Respiratory care practitioners play a major role in helping the patient learn the skills to achieve successful asthma control.

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