Management of asthma Flashcards
Symptoms of Asthma
- wheezing
- sob
- cough
- chest tightness
- nocturnal waking
- more severe asthma
- cyanosis, tachycardia, hyperventilation, inability to talk
INDUCERS
DUST
POLLEN
ANIMAL DANDER
CIGS
POLLUTION
FLOUR
ASPIRIN
BETA BLOCKERS
VIRUSES
COLD AIR
ANXIETY/STRESS
LAUGHTER
Diagnosis
Spirometry
- FEV1/FVC RATIO
- BRONCHODILATOR REVERSIBILITY
DIFFERENTIAL DIAGNOSIS
COPD
BRONCHIECTASIS
CYSTIC FIBROSIS
OTHER RESPIRTORY DISORDERS
GORD
INFECTIONS
HEART FAILURE
GOALS OF ASTHMA CONTROL
- NO DAYTIE SYMPTOMS
-NO NIGHT AWAKENING
-NO NEED FOR RESCUE MEDS - NO EXCERCISE LIMITATIONS
- NO ASTHMA ATTACKS
- NORMAL LUNG FUCNTION
- MINIMAL SIDE EFFECTS FROM MEDS
MANAGENT OF CHRONIC ASTHMA
SABA
- INHALED SABA
- ALL PT WITH SYMPTOMATIC ASTHMA SHOULD HAVE THESE
- HIGH USAGE MARKER OF POOR CONTROL
- CHECK INHALER TECHNIQUE
INHALED CORTICOSTEROIDS = MOST EFFECTIVE CONTROLLER - ICS SHOULD BE SHOULD BE CONSIDERED FOR PATIENTS HIGH PROBABILITY OF ASTHMA
- DOSE MAY NEED INCREASING
LABA
- improvement in morning PEF
- improvements in FEV1
- benefit in symptom free days and nights
- benefit in rescue free days and nights
- reduction in the rate of severe asthma exacerbations
MANAGMENT OF ACUTE ASTHMA
WHAT TO DO IN AN ASTHMA TTACK :
- SIT UP STRAIGHT AND KEEP CALM
- TAKE ONE PUFF OF YOUR RELIEVER EVERY 30-60 SECS FOR 10 PUFFS
- RING 999
REPEAT STEP 2
MODERATE ACUTE ASTHA
- INCREASING SYMPTOMS
PEF GREATHER THAN 50-75%
SEVERE ACUTE ASTHMA
- PEFR 33%-50% OF PREDICTED OR BEST
- RESPIRATIONS OF LESS THAN 25 BREATHS PER MIN
- PULSE OF LESS THAN 110 BEATS PER MIN
LIFE THREATNENING ACUTE ASTHMA
- PEF OF LESS THAN 33%
- SILENT CHEST
- CYANOSIS
- FEEBLE RESPIRATORY EFFORT
- HYOOTENSION
- EXHASUTION, CONFUSION,COMA
NEAR FATAL ACUTE ASTHMA
- RAISED PaCO2 AND/OR REQUIRING MECHANICAL VENTILATION WITH RAISEDMINFLATION PRESSURES
-PROMPT REFERAL TO ITU SAVES LIVES
TREATENT OF ACUTE ASTHMA
- HIGH FLOW OXYGEN 40-60%
- NEBULISED B2 AGONIST DRIVEN BY OXYGEN
- ORAL/IV CORTICOSTEROIDS
