[5] Acute Asthma Exacerbation Flashcards
What is an asthma exacerbation?
An acute episode of airflow obstruction occurring on a background of chronic airway inflammation and airway hyper-responsiveness
What initiates an asthma exacerbation?
A trigger
What might trigger an asthma exacerbation?
- Viral or bacterial infection
- Inhaled allergens
- Environmental irritants
- Emotion
- Medication
- Poor adherence to preventative therapy
How does a trigger cause an asthma exacerbation?
It causes bronchoconstriction and increased mucus production, thereby worsening asthma symptoms
What should be noted in the history with each acute asthma attack?
- Duration of symptoms
- Treatment already given
- Course of previous attack
What are the classifications of asthma attacks?
- Moderate
- Severe
- Life threatening
Can the patient talk in a moderate asthma attack?
Yes
What are the oxygen saturations in a moderate asthma attack?
> 92%
What is the peak flow in a moderate asthma attack?
probs over 50% idk this card was wrong before lol cba to look it up
What is the respiratory rate in a moderate asthma attack?
- ≤40 breaths/min in 2-5 years
- ≤30 breaths/min in 5-12 years
- ≤25 breaths/min in 12-18 years
What is the heart rate in a moderate asthma attack?
- ≤140 BPM in 2-5 year
- ≤30 BPM in 5-12 years
- ≤25 BPM in 12-18 years
Can the patient talk in a severe asthma attack?
No, too breathless
What are the oxygen saturations in a severe asthma attack?
<92%
What is the peak flow in a severe asthma attack?
33-50%
What is the respiratory rate in a severe asthma attack?
- > 40 breaths/min in 2-5 years
- > 30 breaths/min in 5-12 years
- > 25 breaths per min
What is the heart rate in a severe asthma attack?
- > 140BPM in 2-5 years
- > 125BPM in 5-12 years
- > 110BPM in 12-18 years
What are the signs of a life threatening asthma attack?
- Silent chest
- Cyanosis
- Exhaustion
- Arrhythmia
- Hypotension
- Altered consciousness
What is the peak flow in a life threatening asthma attack?
> 33%
What are the oxygen saturations in a life threatening asthma attack?
<92%
What are the differential diagnoses for an acute asthma exacerbation?
- Inhaled foreign body
- Viral-induced infantile wheezing
- Aspiration
When might children with asthma require hospital admission?
If, after high dose bronchodilator therapy, they;
- Have not responded adequately clinically, i.e. there is persisting breathlessness or tachypnoea
- Are exhausted
- Still have marked reduction in their predicted, or usual best, peak flow rate or FEV1
- Have reduced oxygen saturation (<92% in air)
Psychologically, what is important when managing an asthma attack?
Keep calm and reassure child and parents
What is involved in the management of a moderate asthma attack?
- Short acting ß2 agonist via spacer, with face mask under 3
- Oral prednisolone 1-2mg/kg, maximum 40mg
- Monitor response for 15-30 minutes
What dose of short acting ß2 agonist is given in a moderate asthma attack?
2-4 puffs, increasing by 2 puffs every 2 minutes, up to 10 puffs if required
