Acute asthma

Question 1

Moderate asthma attack

Answer 1

PEFR 50-75%

Question 2

Severe asthma attack

Answer 2

PEFR 33-50% best or predicted
HR >110
RR > 25
Can’t speak in full sentances

Question 3

Life threatening asthma attack

Answer 3

PEFR <33%
O2 SATs <92%
Normal pCO2
Exhaustion
Cyanosis
Hypotension
Confusion
Bradycardia
Silent chest

Question 4

Near fatal asthma attack

Answer 4

Raised pCO2
Requiring mechanical vent with raised inflation pressure

Question 5

When is ABG done in acute asthma

Answer 5

SATS less than 92%

Question 6

Stepwise management of severe asthma attack

Answer 6

1. 15L O2 via non rebreathe -> can be titrated down
2. Nebulised salbutamol (5mg)
3. Nebulised ipratropium bromide
4. 40-50mg oral pred, continued for 5 days
5. IV magnesium sulphate
6. IV aminophylline
7. ITU and intubation and ventilation

Question 7

When will pt with acute asthma be admitted?

Answer 7

1.Prev near fatal
2. Pregnant
3. Any life threatening features
4. Severe if fail to respond to initial tx.
5. Attack despite on oral steroid and presentation at nigh

Question 8

Discharge criteria following acute attack

Answer 8

1. Inhaler technique checked and recorded
2. PEFR >75% best or predcuted
3. Stable on discharge meds for 12-24 hrs.