Chief Compliant: The patient is a 50 year old white male with hypertension who complains of wheezing for one day.
History of the Present Illness: Onset, duration, and progression of wheezing; severity of attack compared to previous episodes; cough, fever, chills, purulent sputum; current and baseline peak flow rate. Frequency of bronchodilator use, relief of symptoms by bronchodila-tors. Frequency of exacerbations and hospitalizations or emergency department visits; duration of past exacerbations, steroid dependency, history of intubation, home oxygen or nebulizer use.
Precipitating factors, exposure to allergens (foods, pollen, animals, drugs); seasons that provoke symptoms; exacerbation by exercise, aspirin, beta- blockers, recent upper respiratory infection; chest pain, foreign body aspiration. Worsening at night or with infection.
Treatment given in emergency room and response.
Past Medical History: Previous episodes of asthma, COPD, pneumonia. Baseline arterial blood gas results; past pulmonary function testing.
Social History: Smoking, alcohol.
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If you suffer with asthma, you will no doubt be familiar with the uncomfortable sensations as your bronchial tubes begin to narrow and your muscles around them start to tighten. A sticky mucus known as phlegm begins to produce and increase within your bronchial tubes and you begin to wheeze, cough and struggle to breathe.