Asthma attack.

Question 1

What are the hallmarks of a moderate asthma attack?

Answer 1

Increased RR
Some accessory muscle use
Loud wheeze
Pulse 100-120

Question 2

What are the hallmarks of a severe asthma attack?

Answer 2

Cannot complete a sentence in one breath.
RR of 25 or over.
Pulse of 110 or over.
Peak flow of 50% of the predicted/best flow.

Question 3

What are the hallmarks of a life threatening asthma attack?

Answer 3

Peak expiratory flow under 33% of the predicted/best flow.
Silent chest and cyanosis.
Bradycardia or hypotension.
Exhaustion, confusion or coma.
PaO2 under 8 or PCO2 over 6.

Question 4

What is the treatment of an acute asthma attack?

Answer 4

Oxygen,
Salbutamol (5mg salbutamol men or 4-6 puffs every 20 mins - takes 10-15mins to work).
and Hydrocortisone IV (50mg) or 40mg oral pred for all.

If needed - on advice from senior:
Ipratropium bromide,
Theophylline or aminophylline,
Magnesium sulphate.

These are adult doses.

Remember guidelines and child differences.