ASHTMA

Question 1

RED FLAGS

Question 2

DIFFERENTIALS

Answer 2

• Chest infection
• Anaphylaxis
• Anxiety
• Bronchiolitis
• Cardiac failure
• COPD
• APO
• Foreign body

Question 3

CAUSES

Answer 3

Genetic & enviro factors

Question 4

PATHOPHYSIOLOGY

Answer 4

IgE mediated Exaggerated inflammatory response that causes variable airway limitation.

Acute phase: Trigger –> immune response (over exaggerates) –> mast cells degranulate + other cytokines & WBCs –> 1. bronchoconstriction, 2. mucus production, 3. inflammation (permeability –> oedema) –> impaired gas exchange –> ventilation/perfusion mismatch –> hypoxia (hypoxaemia & hypercapnia).
- Air trapping & hyperinflation.
- Goblet cell hyperplasia –> mucus production.
- Bronchoconstriction– smooth muscle contraction.
- Insp & exp wheeze due to lower airway obstruction caused by bronchoconstriction.
- Stridor– laryngeal.
- Basal crackles– due to mucous.
- Skin changes due to sympathetic response, cyanosis due to hypoxia.

Chronic phase: Constant frequent acute phases –> scarring –> decrease alveolar elasticity/compliance & emphysema-like alveolar septal degradation  decrease medication response due to scar tissue not being responsive to the medication.
- Severe cases –> barotrauma, respiratory arrest.

Question 5

TREATMENT

Answer 5

PRIMARY
D: asthma severity- IM Adrenaline. RA: advanced airway. B: O2, NEB Salbutamol/Ipratropium bromide, IPPV/CPAP. CD: Hydrocortisone, CCP: Mg sulphate. E: Position Pt. upright/position of comfort.

SECONDARY
Thorough RSA + reassessments.

Question 6

ROLE OF PARAMEDIC

Question 7

DEFINITION

Answer 7

A chronic inflammatory disease of the resp. system characterised by bronchial hyperresponsiveness, episodic acute exacerbations, & reversible airflow obstruction.