Acute asthma

Question 1

When should patients with acute asthma attack be admitted

Answer 1

Life-threatening attack, symptoms of severe attack if failing to respond to initial treatment, previous near fatal attack, pregnancy, attack even though already using oral corticosteroid and presentation at night

Question 2

What type of oxygen should be used and when

Answer 2

If patients are hypoxaemic, if acutely unwell then 15L supplemental via non-rebreath mask which can then be titrated down

Question 3

When are SABAs used

Answer 3

In all patients. If non life threatening then pMDI or oxygen driver nebuliser. If severe features then nebulised SABA

Question 4

When are corticosteroids used

Answer 4

All patients given 40-50mg of prednisolone orally. Continued for 5 days.

Question 5

When is ipatropium bromide used

Answer 5

Severe or life-threatening asthma attack or those who have not responded to SABA or corticosteroid.

Question 6

Features of severe asthma attack

Answer 6

PEFR 33-50%, can’t complete sentences, RR >25, pulse >110