Emergency physicians have the opportunity to educate patients and prescribe chronic inhaled corticosteroids to patients who should be on these medications chronically. Patients may be more receptive to education and advice given immediately after an asthma exacerbation, managed in the ED. Using the
National Institute of Health/ National Asthma Education and Prevention Program classification system, physicians can quickly determine if the patient is a candidate for inhaled corticosteroids and initiate therapy accordingly.
In short, patients can be classified into one of four classes: intermittent, mild persistent, moderate persistent, and severe persistent asthma. Patients in these classes should receive either Step 1, 2, 3, or 4/5 medications, respectively. I remember that patient using daily short-acting beta agonists (SABA) belong to the moderate persistent asthma category.
For the complete report from the 2007 National Heart, Lung, and Blood Institute Guidelines, go to: