Acute Asthma

Question 1

What are the red flags for an acute asthma attack?

Answer 1

Cyanosis

Silent chest

Confusion, sedation

Question 2

What is the medication for a mild acute asthma attack?

51-75 PEFR

Answer 2

Salbutamol

2 puffs every two minutes but increasing the number of puffs by two each time up to a maximum of 10 and reassess after one hour:

Repsonse - salbutamol prn 1-4 hourly and orl prednisolone for3-5 days

Non responders - refer to hospital

Question 3

What is the medication for a severe acute asthma attack?

33-50 pefr

Answer 3

Investigations - ABG, sputum and cultures

Treatment -

100% oxygen

B2 agonists via nebuliser every 20-30 minutes

Antimuscarinincs (ipatropium) every 4-6 hours

Steroids IV or oral

Question 4

What is the medication for a life threatening acute asthma attack?

<33%

Answer 4

ITU, intubation and ventilation

IV B2 agonist, magnesium sulphate and aminothyline

Question 5

When can a patient be discharged?

Answer 5

1. PEFR over 75 after one hour
2. not life threatening
3. No persisting features or signs

Stable on inhalers for 24 hours if it was initially below 75

Question 6

What do you always do on discharge?

Answer 6

Written review plan and see in 30 days