Acute Asthma

Question 1

What can cause an acute exacerbation of asthma?

Answer 1

Infection
Exercise
Cold weather

Question 2

What are the signs and symptoms of an acute asthma attack?

Answer 2

Worsening SOB
use of accessory muscles
Tachypnoea
Expiratory wheeze

Question 3

How is moderate asthma graded?

Answer 3

Peak expiratory flow = 50-75% of predicted best.

Question 4

How is severe asthma graded?

Answer 4

Peak expiratory flow rate = 33-50% of predicted best.
RR > 25
HR >110
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Question 5

How is life-threatening asthma graded?

Answer 5

Peak expiratory flow rate = <33% of predicted best
O2 sats = <92%
Tired
No wheeze (silent chest)
Haemodynamic instability

Question 6

What is the treatment of moderate asthma?

Answer 6

Nebulised Beta2 agonist (salbutamol 5mg)
Nebulised ipratropium bromine
Steroids - oral prednisolone or IV hydrocortisone for 5 days
Antibiotics (only if infection)

Question 7

What is the treatment of severe asthma?

Answer 7

Oxygen - maintain sats between 94-98%
Aminophylline infusion
IV salbutamol

Question 8

What is the treatment for life threatening asthma?

Answer 8

IV magnesium sulfate
Admission to HDU/ICU
Intubation - must be done early

Question 9

What is the initial ABG of acute asthma patients?

Answer 9

Respiratory alkalosis - due to tachypnoea blowing off too much CO2.
(good sign as shows they’re still breathing)

Question 10

What is a bad ABG in acute asthma?

Answer 10

Normal PCO2 or Hypoxia (low. O2) - shows they are tiring and are not breathing as much.

Question 11

What is the worst ABG in acute asthma?

Answer 11

Respiratory acidosis - can’t even blow off the CO2.

Question 12

What are the side effects of salbutamol?

Answer 12

Tachycardia

Low potassium levels (absorbed from the blood into cells)