Asthma Secondary Survey

Question 1

Asthma - Secondary Survey Intro

Answer 1

If there were no features of severe/life-threatening/near-fatal (see section 2), I would continue on to secondary.

If the patient was in too much distress I would begin my treatment (see section 2) and move on to the secondary survey where possible.

Help to rule out differential.

Question 2

Asthma - HPC:

Answer 2

HPC:

• Onset (gradual)
• Trigger (infection, allergy, exertion)
• Cough
• Sputum
• Pain assoc with breathing (Pneumothorax differential)

Question 3

Asthma - RMH

Answer 3

• Diagnosis?
• Other respiratory issues
• Surgeries
• Smoker
• Previous hospital admission
• Family history

Question 4

Asthma - Meds

Answer 4

-Inhaler
o Reliever inhalers (blue) beta2-agonist (salbutamol)
o Preventer inhalers (brown, red or orange) ?corticosteroids
o Nebuliser

• Oral Steroids – Powerful anit-inflammatory preventers (when other treatment fails)
• Other oral meds
• Personal asthma action plan
• Bronchial thermoplasty (new)

Question 5

Asthma - Inspection

Answer 5

o Hands/feet – colour, warmth,
o Face – pursed lip breathing, cyanosis
o Resp rate, rhythm, depth, effort
o Thorax – recession, eq rise (pneumo differential) , chest shape (COPD?)

Question 6

Asthma - Palpate

Answer 6

o Bony structures – differential for trauma
o Tracheal deviation – differential for pneumo
o Tactile fremitus – consolidation
o Respiratory excursion – (pneumo diff)

Question 7

Asthma - Percuss

Answer 7

o Consolidation

o Asthma – hyper-resonance

Question 8

Asthma - Auscultation

Answer 8

o Eq bi lat AE
o Wheeze
o Crackles – fluid/infection
o Bronchial and vesicular sounds where meant to be

Question 9

Asthma - ECG

Answer 9

RULE OUT CARDIAC INVOLVEMENT