Acute Exacerbation of COPD/ Asthma Flashcards
What are the signs of a severe and life threatening asthma attack?
- Inability to complete sentences
- Pulse over 110
- Resp Rate >25
- PEFR 33-50% if severe, <33% if life threatening
LT: - Silent Chest
- Bradycardia
- Type 2 Respiratory failure
- Confusion
- Exhaustion
- Cyanosis
What are the signs of a COPD exacerbation?
- Dyspnoea
- Cough
- Expiratory Wheeze
- Sputum Changes
- Tachypnoea
What investigations for asthma/ COPD?
Pulse Ox (low Sats for COPD)
Bloods- FBC for WCC (eosinophilia/ neutrophilia in asthma), U&E, CRP, IgE, (PVC inc. in COPD)
Sputum/ Blood culutre
Chest X ray- IECOPD or lung changes, hyperinflation, dilation of central arteries
ABG - ?respiratory failure
PEFR and Bronchodilator reversibility test- irreversible obstructive if COPD
Bronchial challenge (histamine)- ASthma gets worse
Spirometry
- FEV1/FVC < 70%
- FVC <80%
- Increased TLC/ RV
- DLCO reduced
ECG (cor pulmonale)- right atrial and ventricular hypertrophy
What is the treatment for an acute exacerbation of asthma?
- Salbutamol nebuliser (2.5mg-5mg)
- IV hydrocort or Oral pred
- Budesonide
- Salmeterol (LABA)
- Aminophylline
- Magnesium sulphate
What is the treatment for an acute exacerbation of COPD?
- Salbutamol
- Oral pred
- PT for mucus
- Oxygen
- Antibiotics if infective
- Positive pressure ventilation (both invasive and non invasive)
What is the difference between COPD and asthma?
Asthma is a reversible airway obstruction whereas COPD is reversible (it encompasses emphysema and chronic bronchitis)
What is the maximum flow a nasal cannula can hold?
4L
