Asthma Flashcards
1
Q
What are the signs of a moderate asthma attack?
A
talk in full sentences soft wheeze - inspiratory some shortness of breath RR < 25 HR < 110 PEFR 50-75% normal SpO2 >92%
2
Q
What are the signs of a severe asthma attack?
A
PEFR 33-50% best or predicted SpO2 > 92% can't complete sentences RR > 25 Pulse > 110
3
Q
What are the signs of a life-threatening asthma attack?
A
PEFR < 33% best or predicted SpO2 <92% Silent chest, cyanosis or feeble respiratory effort Bradycardia, dysrhythmia or hypotension exhaustion, confusion or coma Blood gas: PaO2 < 8, normal/high PaCO2
4
Q
What is the management pathway for an acute severe/life-threatening asthma attack?
A
Salbutamol 5mg (or terbutaline 10mg) nebulised with O2 - can be given every 15 minutes Give prednisolone 40-50mg or IV hydrocortisone 100mg
If no improvement, give ipratropium bromide 0.5mg 4-6 hourly
Single dose IV magnesium sulphate 1.2-2g over 20 minutes. Also consider IV salbutamol 250 microg over 5 mins bolus
Consider adrenaline IM 0.3mg or IV 50 microg
If no improvement consider IV aminophylline 5mg/kg loading over 20 mins then 05-0.7mg/kg/hr
ICU consultation and admission is very important
5
Q
What are the main side effects of salbutamol?
A
tachycardia, arrhythmias, tremor, hypokalaemia
6
Q
What are the differentials that should be considered in acute asthma?
A
acute infective exacerbation of COPD pulmonary oedema upper respiratory tract obstruction pulmonary embolus anaphylaxis
