Acute Asthma Flashcards
What is Asthma?
A chronic inflammatory condition that causes reversible and paroxysmal obstruction of the bronchioles
What causes it? (3)
- Bronchial Muscle contraction (triggered by multiple stimuli)
- Mucosal swelling and inflammation (caused by mast cells and basophils)
- Increased mucous production
What happens if asthma isnt treated?
It can be life-threatening, or long term it can cause fixed airways disease
Is it common?
Yes very, it affects 5-8% of the population, 1 in 12 people
Who does it affect?
It mostly affects children and is the most common chronic condition of childhood
Risk factors (10)
Atopy (allergic rhinitis and eczema), family history, inner city environment, socio-economic deprivation, obesity, prematurity and low birth weight, viral infections in early childhood, smoking, maternal smoking, early exposure to broad spectrum antibiotics
Symptoms (3)
Intermittent dyspnoea, nocturnal cough, sputum
Signs (6)
Wheeze, morning reduction in peak flow, tachypnoea, hyperinflated chest, reduced air entry, tachycardia
What are the life-threatening signs? (4)
Silent chest, cyanosis, hypercapnoea, confusion
What are the precipitants for asthma?
Cold air, exercise, emotion, allergens, infection, smoking, pollution, NSAIDs, Beta blockers
Differentials (6)
Bronchiolitis, Cystic fibrosis, GORD, Croup, Bronchiectasis, COPD
Investigations (4)
Peak flow, lung function tests, spirometry, chest xray
What is the first step treatment? (1)
Occasional short acting beta agonist use e.g Salbutamol
What is the second step treatment? (2)
Daily inhaled steroid e.g Beclamethasone and use of Beta agonist for rescue e.g Salbutamol
What is the third step treatment? (3)
Addition of long acting beta agonist e.g Salmeterol, increase dose of Beclamethasone, add Leukotriene Receptor Antagonist
What is the fourth step treatment? (1)
Increase steroid dose
What is the fifth step treatment? (2)
Oral and high dose inhaled steroids, refer to respiratory physician
What is the treatment for acute life-threatening asthma? (5)
15 litres oxygen non-rebreathe mask, 5mg Nebulised Salbutamol with 5litres oxygen, 100mg Hydracortisone, 5mg Ipratropium, Single dose Magnesium Sulphate, ask for senior help
What are the complications? (6)
Pneumonia, pneumothorax, pneumomediastinum, respiratory failure, respiratory arrest, death
Is there a good prognosis?
1000 asthma deaths in UK per year, but most children grow out of asthma
Is there any way to prevent it?
Hygiene hypothesis, breast feeding, smoking cessation, maternal diet
