Mod D Tech 8 Respiratory conditions asthma

Question 1

Medical/Respiratory Disorders affecting the Respiratory System Name conditions

Answer 1

Asthma Chronic bronchitis Emphysema Pneumonia Pulmonary embolus

Question 2

Asthma 4 presentations

Answer 2

Mild/moderate Severe Life-threatening Near fatal

Question 3

Asthma can be triggered by a number of factors e.g.

Answer 3

allergens (pollen, dust, foodstuffs), aspirin, infection, stress, cold air or smoke

Question 4

Pathology of asthma

Answer 4

The initial reaction involves spasmodic contraction of the bronchi and bronchioles. Inflammation of the bronchi and bronchioles. Increased mucus secretion. Oedema may follow to further complicate the condition.

Question 5

Adult Asthma

Answer 5

Acute Severe Asthma Unable to complete a sentence in one breath Respiratory rate >25 Heart rate >110 PEF 33% - 50% of predicted normal Life Threatening Asthma Silent chest Cyanosis Poor respiratory effort Bradycardia or hypotension Exhaustion, confusion, coma PEF <33% of predicted normal SpO2 <92%

Question 6

Asthma in Children

Answer 6

Acute Severe Asthma SpO2 <92% on air Too breathless to talk or feed Respiratory rate >50 (2 – 5 yrs), >30 (5 – 18yrs) Heart rate >130 (2 – 5 yrs), >120 (5 – 18 yrs) PEF <50% of predicted normal Life Threatening Asthma - SpO2 <85% in air Silent chest Cyanosis Poor respiratory effort Fatigue or exhaustion Agitation or reduced conscious level PEF <33% of predicted normal

Question 7

Management of Asthma

Answer 7

Question 8

Management of Asthma (1)

Answer 8

Ensure ABC’s

Administer Oxygen therapy if hypoxaemic (maintain SpO2 94-98%)

Consider patient position

Commence transport

Specifically consider:

Check peak flow if practicable – note the best of 3 Administer Salbutamol

In acute severe or life threatening cases Ipratropium should be administered with the salbutamol

Question 9

Management of Asthma (2) In cases of hypoventilation consider

Answer 9

in-line nebulisation with BVM and nebuliser

Monitor using ECG and Pulse Oximeter

Repeat doses of Salbutamol in accordance with guidelines

Exclude pneumothorax

Monitor and reassess to evaluate any change in peak flow or air entry

Consider Paramedic support to administer Hydrocortisone where there is a delay getting to hospital of >30 minutes

Question 10

Treatment of Life Threatening Asthma

Answer 10

Adrenaline 1:1000 IM/SC – repeated after 5 minutes if necessary)

Salbutamol / Ipratropium Bromide

Paramedic support for IV access [do not delay transport]

Paramedic will administer Hydrocortisone IV (if >30 minutes to hospital)

In-line nebulisation with bag, valve, mask in cases of hypoventilation.