Acute Asthma

Question 1

Describe the presentation of an acute exacerbation of asthma

Answer 1

Progressively worsening SOB
Use of accessory muscles
 Tachypnoea
Symmetrical expiratory wheeze 
The chest can sound tight with reduced air entry

Question 2

Describe a moderate asthma attack

Answer 2

PEFR 50-75% predicted

Question 3

Describe a severe asthma attack

Answer 3

PEFR 33-50% predicted
Respiratory rate >25
Heart rate >110
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Question 4

Describe a life threatening asthma attack

Answer 4

PEFR <33%
SATS <92%
Becoming tired
NO wheeze - silent chest 
Haemodynamic instability

Question 5

Describe Treatment of a moderate asthma attack

Answer 5

Nebulised salbutamol
Nebulised ipratropium bromide
Steroids - prednisolone or hydrocortisone
antibiotics if signs of infection

Question 6

What is the treatment of a severe asthma attack?

Answer 6

oxygen if required to maintain sats

aminophylline infusion consider IV salbutamol

Question 7

What is the treatment of a life threatening asthma attack?

Answer 7

IV magnetism sulphate infusion
admission to HDU .ITU
Intubation - decision needs to be made early

Question 8

Describe ABGs in asthma

Answer 8

Initially respiratory alkalosis.
normal PCO2 or hypoxia is a concerning sign as it means they are tiring and indicates a life threatening asthma attack
respiratory acidosis is a very bad sign