5.2.1 Acute Asthma

Question 1

When is a child having severe asthma attack?

Answer 1

-Can’t talk in full sentences
-accessory muscle use
-tracheal tug
-respiratory distress
O2 sates, 90-94%

Question 2

When is asthma life threatening?

Answer 2

Reduced consciousness
Cyanosis
Exhaustion
O2 says <90%
Absent breath sounds

Question 3

What is the moderate exacerbation treatment for salbutamol?

Answer 3

Hour of power
<6yrs: 6 puffs
>6yrs: 12 puffs
20min x 3 times

Question 4

When do you use nebuliser salbutamol?

Answer 4

Life threatening attack
Continuous
<6yrs 5mg
>6yrs: 10mg
With ipratropium

Question 5

Do you use oxygen in asthma attack?

Answer 5

If sats are under 94%

Question 6

What do you do if life threatening asthma and giving continuous salbutamol and no response?

Answer 6

Consider:
IV salbutamol
IV Mag
IV aminophylline

Question 7

Nebuliser vs. spacer?

Answer 7

No difference really

Question 8

When is oral corticosteroids not useful?

Answer 8

ED Rx of preschoolers <5yrs with viral wheeze

Question 9

ICS vs. LTRA (leukotriene receptor antagonist)

Answer 9

intermittent LTRA more effective than ICS

Question 10

Montelukast (LTRA) vs. pred?

Answer 10

Pred was better

Question 11

Is IV magnesium sulphate good to use in acute asthma?

Answer 11

Yes
Reduced hospitalisation
Improved lung function
NNT = 4

Question 12

Is nebulised magnesium sulphate effective in asthma?

Answer 12

Not more than IV mag sulphate

Question 13

When is child ready for d/c with asthma attack?

Answer 13

When clinically stable on 3rd hourly bronchodilator

Question 14

Oximetry for criteria for discharge in asthma attack?

Answer 14

Nope. Use as a guide only.

Question 15

Discharge plan for child who had an asthma attack?

Answer 15

Discharge summary
Asthma management plan
Discharge meds
Follow up arrangements