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Year Three - Paediatrics > Acute Asthma > Flashcards

Acute Asthma Flashcards

1
Q

What is asthma?

A

It is a chronic inflammatory airway disease leading to variable airway obstruction

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2
Q

What hypersensitivity reaction is associated with asthma?

A

Type I hypersensitivity reaction

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3
Q

What is acute asthma?

A

It refers to a rapid deterioration in the clinical features of asthma

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4
Q

What are the three common triggers of acute asthma?

A

Infection

Exercise

Cold weather

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5
Q

What are the six clinical features associated with acute asthma?

A

Nocturnal Cough

Dyspnoea

Respiratory Distress Features

Tachypnoea

Expiratory Wheeze

Silent Chest

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6
Q

What does a silent chest indicate?

A

It is an ominous sign, indicating that the airways have become so tight that there is no movement of air to create a wheeze

It may also be associated with reduced respiratory effort due to fatigue

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7
Q

What are the three classifications of acute asthma?

A

Moderate

Severe

Life Threatening

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8
Q

What are the four clinical features of moderate acute asthma?

A

PEFR > 50% Predicted

Normal Speech

Normal RR

Normal HR

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9
Q

What are the five clinical features of severe acute asthma?

A

PEFR 33-50% Predicted

Impaired Speech

Respiratory Distress Features

RR > 40 (1-5 yrs old), RR > 30 (> 5 yrs old)

HR > 140 (1-5 yrs old), HR > 125 (> 5 yrs old)

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10
Q

What are the seven clinical features of life threatening acute asthma?

A

PEFR < 33%

Saturations < 92%

Poor Respiratory Effort

Silent Chest

Hypotension

Cyanosis

Confusion/Coma

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11
Q

How do we manage moderate acute asthma attacks?

A

Salbutamol inhalers via a spacer

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12
Q

What dose of salbutamol inhalers is initially tried in moderate acute asthma attacks?

A

4-6 puffs every 4 hrs

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13
Q

What are the seven management options for severe acute asthma attacks? List it in the stepwise order

A

Salbutamol Inhalers

Nebulisers With Salbutamol/Ipratropium Bromide

Oral Prednisolone

IV Hydrocortisone

IV Magnesium Sulphate

IV Salbutamol

IV Aminophylline

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14
Q

What dose of salbutamol inhalers is initially tried in severe acute asthma attacks?

A

10 puffs every 2 hrs

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15
Q

What drug class does salbutamol belong to?

A

Beta 2 agonists

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16
Q

What are the three side effects of salbutamol?

A

Tachycardia

Tremor

Hyperkalaemia

17
Q

How does salbutamol cause hyperkalaemia? How do we manage this?

A

It causes cells to absorb increased amounts of potassium from the blood

We conduct monitoring of serum potassium in patients who are administered high doses of salbutamol

18
Q

What drug class does ipratropium bromide belong to?

A

Anti-muscarinic

19
Q

What dose of oral prednisolone is advised in severe acute asthma attacks?

A

1 mg per kg of body weight once daily for 3 days

20
Q

Once individuals are admitted to hospital with severe acute asthma, how often should they be reviewed? Why?

A

They are reviewed prior to each next dose their bronchodilator

In order to determine whether their management needs to be stepped up or down

21
Q

How do we manage severe acute asthma attacks, once control has been established?

A

It is important to utilise a stepwise approach to gradually reduce the administered medications

22
Q

What is a typical step down regime for inhaled salbutamol? (5 steps)

A

10 puffs every 2 hrs

10 puffs every 4 hrs

6 puffs every 4 hrs

4 puffs every 6 hrs

2 - 4 puffs as required

23
Q

At what step should acute asthma patients be considered for discharge?

A

When they are well on a dose of 6 puffs of salbutamol every 4 hrs

24
Q

What three things should be conducted prior to discharge of acute asthma patients?

A

They should be prescribed a reducing regime of salbutamol to continue at home

They should be advised to finish their course of steroids, which is usually a 3 day course

They should be given an individualised written asthma action plan

25
Q

How do we manage life threatening acute asthma attacks?

A

We need to call an anaesthetist and the intensive care unit

This is due to the fact that they may require intubation and ventilation

Year Three - Paediatrics (29 decks)

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