Respiratory

Question 1

How is severe asthma treated?

Answer 1

10mg salbutamol (5mls) Nebulised    +
500mcg Atrovent (2mls) Nebulised

Repeat salbutamol 5mg @ 5/60

If patient worsens= IM adrenaline 500mcg

Question 2

In severe asthma, when should IM adrenaline be administered?

Answer 2

If there is no response to nebulised therapy, if patient continues to speak single words or if rapidly deteriorating.

Question 3

What is the treatment for an asthma patient who becomes unconscious with a pulse?

Answer 3

• Immediate Ventilations at 6-7ml/kg @ 5-8 vents/min

* Allow for prolonged exploratory phase

Question 4

When an asthmatic patient looses cardiac output, what is the first action and why?

Answer 4

• Patient needs immediate assisted expiration and apnoea for 1min
• This is because the intrathoracic pressure is high due to gas trapping therefore venous return is compromised

Question 5

Exacerbation of pre existing COPD can be defined as:

Answer 5

• increased dyspnoea
• increased cough
• increased sputum production

Question 6

What are the indications for CPAP?

Answer 6

Sp02 of

Question 7

What are the reasons to cease CPAP?

Answer 7

• Arrest
• Clinical deterioration
• No improvement after 1 hour

-HR

Question 8

What is the treatment for COPD?

Answer 8

Irrespective of severity:

Salbutamol 10mg + 500mcg Atrovent

Question 9

When treating COPD, after nebulised salbutamol and Atrovent what happens when there is adequate response or inadequate response?

Answer 9

Adequate: titrate 02 to nasal prongs Sp02 88-92%

Inadequate: CPAP (mica)

Question 10

What are the 3 possible causes of upper airway obstruction?

Answer 10

• Partial obstruction
• Croup
• Suspected Epiglottitis

Question 11

How is mild-moderate asthma treated?

Answer 11

First administer Ventolin. 4 breaths/4 doses.

-if no Ventolin

Salbutamol 10mg (5mls) nebulised. 
Repeat 5mg (2.5mls) neb after 5min