Dyspnea and wheezing are common complaints in the hospital setting. Approximately 8% of patients present to the emergency department reporting dyspnea1. Asthma exacerbations are a common cause of dyspnea and wheezing. Asthma is the 11th most common diagnosis in the ED and the most common ED diagnosis in patients under age 172. Unfortunately, the high prevalence of asthma plus the strong association between these symptoms and asthma can lead physicians to anchor on this diagnosis when patients present with dyspnea and wheezing.