Acute Asthma

Question 1

Acute Asthma Definition:

Answer 1

Exacerbation of Asthma:
Increasing breathlessness, chest tightness, coughing, and/or wheezing, that does not respond to standard treatments of bronchodilators and steroids.
Exacerbations are marked by decreases from baselinei n objective measures of pulmonary function, such as peak expiratory flow rate and FEV1.

Question 2

Acute Asthma: Staging: Describe * Moderate
Moderate
Severe
Life Threatening 
Near Fatal

Answer 2

Able to speak & complete sentences
Heart Rate < 110
Respiratory Rate < 25
PEFR 50-75% predicted or best
SaO2 > 92% (no need for ABGs)
PaO2 > 8kPa

Question 3

Acute Asthma: Staging: Describe * Severe
Moderate
Severe
Life Threatening 
Near Fatal

Answer 3

Unable to speak or unable to complete sentences
Heart Rate > 110
Respiratory Rate > 25
PEFR  33-50% predicted or best
SaO2 > 92% (no need for ABGs)
PaO2 > 8kPa

Question 4

Acute Asthma: Staging: Describe * Life Threatening 
Moderate
Severe
Life Threatening 
Near Fatal

Answer 4

Grunting 
Impaired consciousness, confusion, exhaustion
Heart Rate > 130 OR Bradycardia
Hypoventilating
PEFR  < 30% predicted or best
SaO2 < 92% (no need for ABGs)
PaO2 < 8kPa
PaCO2 < or normal (4.6-6.0kPa)

Question 5

Acute Asthma: Staging: Describe * Near Fatal 
Moderate
Severe
Life Threatening 
Near Fatal

Answer 5

Raised PaCO2

Question 6

Acute Asthma: Investigations

Answer 6

PEFR
ABG’s
Bloods, FBC, U&E’s CRP, Blood Culture

Question 7

Acute Asthma: Management

Answer 7

1. Check if patient is able to speak/complete sentences (airway), Check Respiratory Rate (Breathing), Check Heart Rate (Circulation), Check PEFR, Check Oxygen Sats.
2. Sit patient upright
3. Oxygen via nebuliser mask
4. IV or nebulised steroids
5. IV/oral Amoxicillin