Asthma Flashcards
Define Asthma
Asthma is a reversible airways disease causing bronchospasm, mucosal oedema and mucosal plugging. It may be triggered by allergens, weather, illness or emotional state.
Asthma V’s Bronchiolitis
Children under the age of 2yrs are often diagnosed with bronchiolitis rather than asthma when they present with a wheeze.
Bronchiolitis refers to inflammation of the bronchioles and has a viral cause. Bronchospasm does not occur.
Consider that salbutamol isn’t probably going to work very well, atrovent works better.
Asthma Management (Mild/Mod)
- Determine Severity
- If Mild/Mod = Salbutamol
>6yrs - 4-12 puffs
<6yrs - 2-6 puffs (4 breaths after each dose) - Repeat as required after 20/60)
Asthma Management (Severe)
If Severe or salbutamol puffer unsuccessful after 20/60 administer salbutamol and atrovent neb with oxygen 8lpm
Small child (2-4yrs) = 2.5mg salbutamol + Atrovent 250mcg
Medium child (5-11yrs) = 2.5-5mg salbutamol + Atrovent 250mcg
Can repeat salbutamol neb 20/60
- Always make volume up to a minimum of 5ml (add saline if need be)
Asthma Management (Critical)
- Salbutamol neb 10mg (repeat 5/60 if need)
- Atrovent 250mcg neb (once only)
- Adrenaline 10mcg/kg every 5-10min (max 3 doses)
- Dexamethasone 600mcg/kg (max 12mg)
- Assist with ventilations as required
Asthma Management - Assisted Ventilations points to remember
- Use higher airway pressures
- Allow for prolonged expiratory phase
- Apply lateral chest pressure during expiration
- Be mindful of barotrauma risk
- Tidal volume - aim for adequate chest rise and fall
- lower rate to allow for trapped air to get out
SMALL CHILD (2-4yrs) = 12-15 ventilations
MEDIUM CHILD (5-11yrs) = 10-14 ventilations
Unconscious Asthma patient that loses cardiac output (what do we do)
- Allow 30 seconds of apnoea
- Exclude tension pneumothorax
- Continue lateral chest pressure
- Prepare to commence cardiac arrest guidelines
