Got asthma? Don’t smoke or vape pot
Jason came into the emergency department complaining of shortness of breath. His girlfriend Sarah spoke for him because he was having such a hard time breathing. She said they had been outside walking their dog in the park when Jason started having trouble breathing. He had a history of asthma and had an inhaler for flare ups, but he hadn’t brought it with him that afternoon.
Even without using her stethoscope, the triage nurse could hear Jason wheezing just sitting across from him. She helped him to a wheelchair, brought him back to a room, and assisted him into the bed. She asked me to see him as soon as possible.
When I walked into his room, Sarah was sitting on the side of the bed holding Jason’s hand and encouraging him to stay calm and slow his breathing. I listened to Jason’s lungs as she told me what had been going on. He looked distressed. I could see him using the muscles in his neck and chest to help him breath as he sat. When I listened with my stethoscope, all I heard was wheezing. He was able to say a few words, but had a hard time talking.
Jason’s nurse put an IV in his arm and we gave him a dose of steroids. The respiratory therapist gave him a breathing treatment of medication that is inhaled into the lungs and helps open the airways, making it easier to breath. I ordered a chest X-ray.
I looked through Jason’s previous emergency department (ED) records. He had been to the ED several times in the past, always for difficulty breathing related to his asthma. I was hoping that he never got so bad that he re