GERD is a common factor that contributes asthma or airway hyperactivity. GERD causes asthma when the acids in the stomach of a human being back up into the throat (Sidwa, Moore, Alligood, & Fisichella, 2017) . In the process, the acid clogs the esophagus. It is not just the acids that flow back, but also foods and juices. All these cloggings in the esophagus lead to difficulty in breathing.
The heart rate is > 120 beats/min
According to Sundbom, Janson, Malinovschi, & Lindberg (2018), when the oxyhemoglobin saturation in a room is more than 95%, this is normal conditions, and would therefore not cause an individual to have acute episodes of asthma. Additionally, for those with acute asthma, pulsus paradoxus is observed, but it is not unique because it shows itself in a host of conditions such as pulmonary diseases, pressure swings, and so on (Arnold, Wang, & Hartert, 2016) . The patient is normally breathless at rest and not when exercising. While being breathless, the patient’s heart rates have more than 120 beats per minute.
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High-dose inhaled corticosteroid and a leukotriene receptor antagonist plus an oral corticosteroid
The above is effective with those suffering from a severe case of asthma. The high dosage of inhaled corticosteroid, which is sometimes applied orally ensures the suppression of asthma (Wenzel, Jayawardena, Graham, Pirozzi, & Teper, 2016) . It does this by suppressing inflammation and through the targeting of inflammatory genes and switching them off. LKTRAs are responsible for suppressing the inflammatory molecules (Lussier, Hsieh, & Remick, 2016) .
PO2 level < 60 mm Hg
For those who need hospitalization due to asthma, status asthmaticus is an indication because it shows the risk of developing severe and acute asthma. On the other hand, sinusitis increase the chances of infections which cause cancer. Next, confusion, drowsiness, and loss of consciousness set it when one is suffering from cancer (Aldington, & Beasley, 2007) . Lastly, PO2 levels of less than 50 mm Hg are an invocation of an asthma patient that needs hospitalization.
References
Aldington, S., & Beasley, R. (2007). Asthma exacerbations· 5: Assessment and management of severe asthma in adults in hospital. Thorax , 62 (5), 447-458.
Arnold, D. H., Wang, L., & Hartert, T. V. (2016). Pulse oximeter plethysmograph estimate of pulsus paradoxus as a measure of acute asthma exacerbation severity and response to treatment. Academic Emergency Medicine , 23 (3), 315-322.
Lussier, B., Hsieh, T., & Remick, D. (2016). C31 EXPERIMENTAL ASTHMA THERAPIES: Leukotriene Receptor Blockade Decreases Mucin Production Triggered By Acute Ethanol Ingestion In Allergen-Sensitized Mice. American Journal of Respiratory and Critical Care Medicine , 193 , 1.
Sidwa, F., Moore, A., Alligood, E., & Fisichella, P. M. (2017). Diagnosis and treatment of the extraesophageal manifestations of gastroesophageal reflux disease. In Failed Anti-Reflux Therapy (pp. 33-49). Springer, Cham.
Sundbom, F., Janson, C., Malinovschi, A., & Lindberg, E. (2018). Effects of coexisting asthma and obstructive sleep apnea on sleep architecture, oxygen saturation, and systemic inflammation in women. Journal of Clinical Sleep Medicine , 14 (02), 253-259.
Wenzel, S. E., Jayawardena, S., Graham, N. M., Pirozzi, G., & Teper, A. (2016). Severe asthma and asthma-chronic obstructive pulmonary disease syndrome–Authors' reply. The Lancet , 388 (10061), 2742.
