Asthma

Question 1

Course of action indicated with mild/moderate asthma?

Answer 1

Move to a calm, quiet environment
Encourage use of own inhaler, preferably using a spacer
Ensure correct technique is used; two puffs, followed by two puffs every 2 minutes to a maximum of 10 puffs
Administer high levels of supplementary oxygen
Administer nebulised salbutamol using an oxygen driven nebuliser

Question 2

At what point is a course of action indicated with severe asthma required?

Answer 2

When initial nebulised salbutamol fails to relieve symptoms

Question 3

Course of action indicated with severe asthma?

Answer 3

If no improvement after nebulised salbutamol administer ipratropium bromide by nebuliser
Administer steroids, hydrocortisone
Continuous salbutamol nebulisation may be administered unless clinically significant side effects occur

Question 4

At what point is a course of action indicated life-threatening asthma required?

Answer 4

If no improvement occurs after administering all 3

• Ipratropium bromide
• Hydrocortisone
• Additional dose of salbutamol

Question 5

Course of action indicated with life-threatening asthma?

Answer 5

Administer adrenaline (IM only)
Assess for bilateral tension pneumothorax and treat if present
Provide an alert/information call

Question 6

When is asthma considered near fatal?

Answer 6

When the patient continues do deteriorate after all courses of treatment

Question 7

How do you assess whether a time critical transfer is required?

Answer 7

As you process through the asthma treatment algorithm consider the patients overall response to treatment and transfer dependent on responsiveness to treatment