RRAPID ASTHMA

Question 1

Symptoms (3)

Answer 1

• SOB
• cough - worse at night
• tight chest

Question 2

signs (2)

Answer 2

1. use of accessory muscles

2. wheeze

Question 3

acute asthma (4)

Answer 3

1. incomplete sentences
2. RR > 25 b/m
3. hr >/= 110 bpm
4. PEFR 33-50% predicted

Question 4

life threatening asthma (13)

Answer 4

1. PEFR < 33%
2. O2 sats < 92% on air
3. PaO2 < 8kPa
4. rising PaCO2
5. silent chest
6. cyanosis
7. feeble resp effort
8. bradycardia
9. dysarrhythmia
10. hypotension
11. exhaustion
12. confusion
13. coma

Question 5

Fatal (2)

Answer 5

1. raised PaCO2 > 6 kPa

2. requires mechanical ventilation

Question 6

Response (1,5,4)

Answer 6

Airways

1. Position - sit patient up

Breathing

1 . O2 15l/min non-rebreathe mask/ reservoir mask

2. ABG
3. Salbutamol 5mg nebulised
   - repeat 15-20 min intervals
4. Ipratropium bromide
   - 500mcg nebuliser with O2 4-6 hourly
5. CXray

Circulation

1. IV access
2. bloods
3. hydrocortisone 200 mg iV or Prednisolone 40 mg orally
4. Magnesium sulphate 2g IV over 20 mins