Asthma

Question 1

Early clinical manifestations of asthma?

Answer 1

expiratory and inspiratory wheeze, non-productive cough, chest tightness, dyspnea (SOB), anxious/agitated, prolonged expiratory phase, increased RR and HR, decreased PERF

Question 2

Severe clinical manifestations of asthma?

Answer 2

hypoxia, confusion, increased HR and BP, pursed lip breathing, RR > 40, accessory muscle use, flaring nostrils, cyanotic nail beds, diaphoresis and pallor

Question 3

Management/treatment of asthma?

Answer 3

Give supplementary oxygen to treat hypoxia, titrate to maintain an oxygen saturation of 94–98%

Nebulise 5mg of salbutamol with 5-7l/min of oxygen.
Repeat doses as needed every 5 minutes, no max dose.

Nebulise 500mcg of Ipratropium bromide with 5-7l/min of oxygen. ONE DOSE ONLY.

Treat with IV coritcosteroids:
100mg Hydrocortisone in severe/life threatening asthma exacerbation. ONE DOSE ONLY

Adrenaline 1:1000 for life threatening asthma w/ failing ventilation and continued deterioration despite nebuliser therapy.
IM in antero-lateral aspect of thigh 500mcg every 5 minutes if no improvement. No max dose.

Blue light transfer with pre-alert