Acute Asthma

Question 1

Presentation of acute asthma attack

Answer 1

Acute SOB
Wheeze
Trigger

Question 2

Asthma attack triggers

Answer 2

Infection
Travel
Exercise
Cold weather
Dust

Question 3

Ix for acute asthma

Answer 3

PEF
ABG
Bloods

Question 4

ABG findings in acute asthma

Answer 4

PaO2 normal or reduced
PaCO2 decreased

PaCO2 may later rise as pt tires
If PaCO2 is normal or rises - send to ITU for ?intubation

Question 5

Severity of acute asthma

Answer 5

Moderate
Severe
Life threatening

Question 6

Moderate acute asthma

Answer 6

PEF > 50% predicted/best

Question 7

Severe acute asthma

Answer 7

Can’t complete sentences with 1 breath
PEF < 50%
RR > 25
HR > 110

Question 8

Life threatening acute asthma

Answer 8

PEF < 33%
SpO2 < 92%

"CHEST"
Cyanosis
Hypotension
Exhaustion, confusion
Silent chest
Tachy-/brady-/arrhythmias

Question 9

Differentials for acute asthma

Answer 9

Pneumothorax
Acute exacerbation of COPD
Pulmonary oedema

Question 10

Admission criteria for asthma

Answer 10

Life threatening acute asthma

Severe acute asthma persisting despite initial Rx

Question 11

Discharge criteria for acute asthma

Answer 11

Stable on discharge meds > 24 hrs

PEF > 75% 1hr after initial Rx

Question 12

Mx of acute asthma

Answer 12

Sit up
O2
Nebulised Salbutamol 5 mg every 15 mins
Prednisolone 40 mg / IV hydrocortisone 100 mg
Ipratropium 0.5 mg every 4 hrs
Consider aminophyline
If life threatening - MgSO4 2g IV over 20 mins