Acute Asthma Exacerbation

Question 1

What is severe asthma?

Answer 1

PEFR 33 - 50% of best
Cannot complete sentences in 1 breath
Respiratory rate >25/min
Heart Rate >110/min

Question 2

What is life threatening asthma?

Answer 2

PEFR

Question 3

Near fatal

Answer 3

• Raised pCO2 (>6kPa)

Question 4

What is initial treatment for severe asthma?

Answer 4

Management of Severe Acute Asthma (Status Asthmaticus)
ABCDE
o Oxygen – High flow, aim to keep O2 94-98% saturation. ABG if sats

Question 5

If that doesn’t work? (2nd stage treatment)

Answer 5

• Add nebulised 500 micrograms Ipratropium Bromide
• Back to back Salbutamol (Monitor ECGs)
• Give single dose of magnesium sulfate

Question 6

If second stage doesn’t work?

Answer 6

• Urgent ITU or anaesthetic assessment
• Urgent portable CXR W
• IV aminophylline
• Consider IV Salbutamol

Question 7

What are normal blood gas ranges?

Answer 7

pO2 >10.6kPa

pCO2 4.7 - 6 kPa