Asthma Managment

Question 1

What is asthma?

Answer 1

An episodic airway obstruction caused by inflammation in the airways

Question 2

How does an asthma attack occur?

Answer 2

Antigen enters body
TH2 cells are activated and release cytokines
Causes IGE antibodies to catch antigen and present it to mast cells
Causes release of eosinophils and basophils
Causes release of histamine and prostaglandins
Causes narrowing of airways

Question 3

Describe mild asthma?

Answer 3

No cyanosis and oxygen levels greater than 90%
Normal consciousness
Good air entry
No tachycardia
Normal speech
No previous ICU admission

Question 4

Describe moderate asthma?

Answer 4

Oxygen<90%
Tachycardia
Impaired speech
Reduced air entry
Previous ICU admission

Question 5

Describe life threatening asthma?

Answer 5

Cyanosis
Oxygen levels <80%
Little respiratory effort or silent chest
Bradycardia or hypotension
Exhaustion,confusion or coma

Question 6

Describe asthma algorithm?

Answer 6

Move to a quiet, calm environment
Encourage use of own inhaler, preferably with a spacer. 2 puffs every 2 mins to a max of 10 puffs
If no improvement Administer high levels of oxygen
Administer nebulised salbutamol using oxygen driven nebuliser
If no improvement administer ipratropium bromide by nebuliser
If no improvement gain IV access, administer hydrocortisone
Continuous salbutamol may be administered unless side effects occur
If no improvement administer magnesium
Administer IM adrenaline if deterioration continues
Assess for bilateral tension pneumothorax
Pre alert