bronchial asthma attack

Question 1

clinical symptoms

Answer 1

Clinical symptoms
- Attack in second half of night.
- Sudden attack of asphyxia and expiratory dyspnea.
- Non productive cough, headache, dizziness.
- Maximum respiration with hyperinflated chest.
- Use of accessory respiratory muscles.
- Respiratory acidosis
- Tachypnea, tachycardia, increase BP
- Pale color of skin
- Polyphonic wheezes

• Percussion- decrease vocal fremitus, band box sound
• Auscultation- decrease vesicular breathing, dry rales

1. Beginning/Initial
   - Nasal raining
   - Emotional changes
   - Cough
   - Itching
   - Changes of smell/taste
2. During attack
   - Expiratory dyspnea
   - Orthopnea/Tripod posture
   - Central cyanosis
   - Distant rales
3. Stop of attack:
   - Big sputum volume
   - Stop of dyspnea
   - Weakness
   - Sleepy

Question 2

emergency care

Answer 2

• Inhalation short activating beta-2 symphatomimetics
• 10 ml, 2.4% solution theophylline
• IV glucorticoid eg prednisalone
• Inhalation glucocorticoid
• Oxygen therapy
• Inhalation of beta agonist- salbutonol, xanthinine derivatives
• systemic corticosteroids
• 5% glucose infusion 500ml- 1L
• monitoring of arterial blood gases