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Supporting life block > Acute asthma > Flashcards

Acute asthma Flashcards

1
Q

What are the symptoms of asthma?

A

-wheezing
-breathlessness
-chest tightness
-cough
varies over time in their occurence, frequency& intensity

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2
Q

Why are symptoms associated with variable expiratory airflow?

A

due to:

  • Bronchoconstriction
  • Airway wall thickening
  • Increased mucus
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3
Q

What usually triggers symptoms in asthmatic patients?

A
  • Viral infections
  • Allergens
  • tobacco smoke
  • exercise
  • stress
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4
Q

Define acute asthma

A
  • A flare-up or exacerabtion is an acute or sub-acute worsening of symptoms and lung function compared with the patient’s usual status
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5
Q

What is FEV1

A
  • Forced expiratory volume in one second
  • amount of air you can blow out in a second
  • Best marker of airflow obstruction
  • record FEV1 three times and take the highest value
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6
Q

Define peak expiratory flow

A
  • The maximum airflow during a forced expiration beginning with the lungs fully inflated
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7
Q

Describe the characteristics of life-threatening asthma after assessment

A
  • Drowsy
  • confused
  • silent chest
  • Transfer to acute care facility and while waiting: give inhaled SABA and ipatropium bromide, o2, systemic corticosteroid
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8
Q

After the assessment of the patient, when should treatment be started ? What should the treatment entail?

A

-Even in the case of mild/moderate asthma
The treatment:
-SABA: 4-10puffs by pMDI+ spacer, repeat every 20mins for an hour
-Prednisolone: adults 1mg/kg, max 50mg, children 1-2mg/kg, max 40g
-Controlled oxygen (if available): target saturation 93-95% (children 94-98%)
-Transfer to acute care facility if symptoms worsening

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9
Q

What does acute treatment for acute asthma consist of?

A
  • Repeated high dose inhaled( or nebulised) salbutamol+/- ipratropium
  • systemic steroids (oral prednisolone or IV hydrocortisone)
  • oxygen if reduced o2 saturations
  • IV magnesium as a single dose
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10
Q

what are symptoms of asthma associated with

A

variable expiratory airflow due to:

  • bronchoconstriction
  • airway wall thickening
  • increased mucus
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11
Q

What can trigger asthmatic symptoms ?

A
  • viral infections(rhinovirus- the common cold is the most frequent trigger)
  • tobacco smoke
  • exercise
  • stress
  • allergens
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12
Q

Outline the anatomy of an asthma attack

A
  • Blood vessels infiltrated by immune cells
  • Contracted smooth muscle
  • Decreased lumen diamater
  • Inflammation &swelling
  • Increased mucus
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13
Q

How can we improve the spirometry trace of an asthmatic

A

use a bronchodilator

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14
Q

Outline the possible presentation of a pt with a mild exacerbation of asthma

A
  • Talks in phrases
  • Prefers sitting to lying
  • Not agitated
  • Respiratory rate increased
  • Accessory muscles not used
  • Pulse rate 100–120 bpm
  • O2 saturation (on air) 90–95%
  • PEF >50% predicted or best
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15
Q

Outline the possible presentation of a pt with a severe exacerbation of asthma

A
  • Talks in words
  • Sits hunched forwards
  • Agitated
  • Respiratory rate >30/min
  • Accessory muscles in use
  • Pulse rate >120 bpm
  • O2 saturation (on air) <90%
  • PEF ≤50% predicted or best
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16
Q

Outline the presentation of a pt with life-threatening asthma

A
  • Drowsy
  • Confused
  • or silent chest
17
Q

What treatment would we start with mild/moderate asthma

A

1.) SABA(4–10 puffs by pMDI + spacer, repeat every 20 minutes for 1 hour)
2.) Prednisolone (adults 1 mg/kg, max.
50 mg, children 1–2 mg/kg, max. 40 mg)
-Controlled oxygen if available (target 93-95% saturation but 94-98% in children)

18
Q

What treatment would you use for someone with a worsening exacerbation which started off as mild

A 
TRANSFER TO ACUTE
CARE FACILITY and 
While waiting: give inhaled SABA and ipratropium bromide,
-O2
-systemic corticosteroid
19
Q

What does pMDI stand for

A

pressurised metered dose inhaler

20
Q

How can we identify patients at risk of asthma-related death?

A
  • Any history of near-fatal asthma requiring intubation and ventilation
  • Hospitalization or emergency care for asthma in last 12 months
  • Not currently using ICS, or poor adherence with ICS(inhaled corticosteroids)
  • Currently using or recently stopped using prednisolone (OCS)
  • (indicating the severity of recent events)
  • Over-use of SABAs, especially if more than 1 canister/month
  • Lack of a written asthma action plan
  • History of psychiatric disease or psychosocial problems
  • Confirmed food allergy in a patient with asthma
  • Flag these patients for more frequent review
21
Q

What does acute treatment consist of?

A
  • repeated high dose inhaled (or nebulised) salbutamol +/- ipratropium
  • systemic steroids (oral prednisolone or IV hydrocortisone)
  • Oxygen if reduced O2 saturations
  • IV magnesium as a single dose

Supporting life block (28 decks)

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