Respiratory Emergencies

Question 1

Acute exacerbation of Asthma Mx?

Answer 1

• high flow O2
• propped up position
• salbutamol (5mg) nebulization or 10 puff into spacer & face mask
  -mix sal ě ipratropium bromide (500mcg) nebulize
• prednisolone (40-50mg) PO or hydrocortisone (100mg) IV
  If doesn’t work,
• IV Mag Sulph (1.2-2g) over 20 mins
• IV Aminophylline (5mg/kg over 20 mins) ; maintenance dose: (0.5-0.75mg/kg/hr)
  OR
  IVI Salbutamol 5mg into 500ml of 5% dextrose @ 30-60 ml/hr

Discharge if:
- PFR > 75%
Prescribe: PO Tab Prednisolone 40-50mg for 5 days
If PFR <50%
give: inhaler

Question 2

COPD mx?

Answer 2

• low flow (28%) O2 ě venturi mask | maintain SpO2: 88-92%
• salbutamol (5mg) +ipratropium bromide (0.5mg) nebilization
• prednisolone (30mg) PO stat
  OR
  Inj hydrocortisone (100mg)
• if sputum purulent, or CXR= Pneumonia:
  give antibiotics (Amoxicillin, tetracycline or Clarithromycin)
• aminophylline IV