Asthma_flashcards (1)
How is asthma diagnosed?
Asthma is usually diagnosed clinically if the patient responds to treatment. Peak flow can be measured in children over 5 years.
What are the key features of a moderate asthma attack?
SpO2 >92%, Peak flow >50% best or predicted, No clinical features of severe asthma.
What are the key features of a severe asthma attack?
SpO2 <92%, PEF 33-50% best or predicted, Too breathless to talk or feed, HR >125 (>5 years old) or >140 (1-5 years old), RR >30 (>5 years old) or >40 (1-5 years old), Use of accessory muscles.
What are the key features of a life-threatening asthma attack?
SpO2 <92%, PEF <33% best or predicted, Silent chest, Poor respiratory effort, Agitation, Altered consciousness, Cyanosis.
What is the acute management approach for asthma?
ABC approach with high flow O2, burst therapy, bolus therapy, infusion therapy, intubation if necessary, GP follow-up in 48 hrs and clinic follow-up in 4-6 weeks.
How should the response to asthma treatment be assessed?
Assess response by monitoring RR, HR, SpO2, and re-examining the chest.
What medications are used in burst therapy for asthma?
Nebulised salbutamol, nebulised ipratropium bromide, oral prednisolone.
What medications are used in bolus therapy for asthma?
IV magnesium sulphate, IV salbutamol, IV aminophylline.
What medications are used in infusion therapy for asthma?
IV infusion aminophylline, IV infusion salbutamol.
What steps should be taken if a patient with asthma is in panic?
Intubate the patient.
What are the outpatient management steps for asthma?
Respiratory examination, bedside observations (O2), plot height and weight, symptom diary/peak flow diary for over 5 years old, skin prick test/spirometry/pheno-test for further investigations.
What long term management is recommended for asthma?
Salbutamol (3 times a week - step up therapy), very low dose ICS (budesonide), very low dose ICS + LTRA (<5 years) or add LABA (>5 years), low dose ICS +/- LABA, medium dose ICS + LABA + theophylline, medium dose ICS + low dose oral steroids.
How should inhaler technique be performed?
Remove cap from inhaler, shake inhaler, place into back of spacer. Put mask over mouth and nose of child, ensure tight seal. Encourage child to breathe in and out slowly and gently. Once breathing pattern is established, press canister and keep in same position as child continues to breathe in and out slowly, 5 times. Remove mask from child’s face. Repeat in 30 seconds for second dose.
What are the types of inhalers used for asthma and their recommended age groups?
Pressurised metered dose inhaler and spacer: 0-2 years (facemask and spacer), >2 years (spacer alone). Breath-actuated metered dose inhaler: >6 years. Dry powder inhaler: >4 years (not good in acute situations). Nebuliser: any age (acute asthma).
