How is an in-flight asthma exacerbation commonly managed?

• A. Short-acting bronchodilator as prescribed, supplemental oxygen, and descent if symptoms persist
• B. Antibiotics and IV fluids
• C. Immediate intubation
• D. Sit tight and monitor only

Answer: (A)

Managing an in-flight asthma flare centers on rapid relief of airway obstruction, ensuring adequate oxygenation, and escalating care if needed. Start with a fast-acting inhaled bronchodilator (short-acting beta-agonist) administered as the patient normally uses it, ideally with a spacer to maximize lung delivery. Provide supplemental oxygen to maintain a safe oxygen saturation despite the cabin’s reduced ambient oxygen. If symptoms persist after the initial bronchodilator doses, or there are signs of increasing distress, descend to a lower altitude and seek medical assistance. Antibiotics or IV fluids are not routinely indicated for a simple asthma attack, and intubation is only for dire, life-threatening failure of noninvasive measures. Sitting and monitoring alone does not treat the airway obstruction.