Asthma: Severe or Inadequate Response

Question 1

Asthma: Severe or Inadequate Response @20/60 - Treatment Priorities

(Severe: agitated/distressed, markedly increased WOB including accessory muscle use / retraction, speaking in words, tachycardia)

Answer 1

• Salbutamol nebulised:
  
  • AD: Salbutamol 10mg neb, repeat 5mg @ 5/60
  • PD L Child 12-16y: Salbutamol 5mg neb, repeat @ 20/60
  • PD M Child 5-11y: Salbutamol 2.5-5mg neb, diluted with n/saline to 5ml, repeat @ 20/60
  • PD S Child 2-4y: Salbutamol 2.5mg neb, diluted with n/saline to 5ml, repeat @ 20/60
• Ipratroprium Bromide (Atrovent) nebulised:
  
  • AD: Atrovent 500mcg neb, once only
  • PD: Atrovent 250mcg neb, once only
• Adrenaline:
  
  • AD: Adrenaline 500mcg IM, repeat @5-10/60, max 1.5mg