Status Asthmaticus

Question 1

what are the hallmark signs of status asthmaticus

Answer 1

Severe dyspnea (rapid worsening, unable to speak full sentences)
Extreme chest tightness
Absent or minimal breath sounds (Silent Chest = BAD)
Cyanosis (bluish skin, lips, nail beds)
Accessory muscle use, retractions, nasal flaring
Tachypnea and tachycardia
Confusion, agitation, drowsiness

Question 2

what are the late signs of status asthmaticus?

Answer 2

hypotension, bradycardia, respiratory failure, cardiac arrest

respiratory muscle fatigue → CO₂ retention → Hypercapnia
Confusion, drowsiness, stupor (CO₂ narcosis)

Question 3

what are the risk factors?

Answer 3

Poorly controlled asthma (frequent attacks, improper medication use)
Recent respiratory infection (viral or bacterial)
Overuse of SABAs (tolerance & decreased effectiveness)
Exposure to strong triggers (smoke, allergens, chemicals)
Non-adherence to controller medications (ICS, LABAs, LTRAs)
Emotional stress or panic attack (hyperventilation worsens symptoms)

Question 4

what does ABGs show?

Answer 4

Early: Respiratory alkalosis (low CO₂ from hyperventilation)
Late: Respiratory acidosis (high CO₂ due to airway trapping & muscle fatigue)

Question 5

what does PEFR show?

Answer 5

Critically low FEV1 (<40% of predicted or personal best)

Question 6

what does chest x ray do for status asthmaticus?

Answer 6

Done to rule out pneumonia or pneumothorax (not to diagnose asthma)

Question 7

what does Continuous Pulse Oximetry & End-Tidal CO₂ Monitoring do?

Answer 7

Detects early CO₂ retention and worsening hypoxia

Question 8

when is intubation and ventilation done?

Answer 8

for severe respiratory failure?

Question 9

what is given for continuous nebulization?

Answer 9

High-dose inhaled β2-agonists (Albuterol)

Question 10

what does IV corticosteroids (Methylprednisolone, Hydrocortisone) do?

Answer 10

reduce inflammation

Question 11

what does IV magnesium sulfate do?

Answer 11

relaxes smooth muscles in airways

Question 13

what does IV ketamine do?

Answer 13

reduces airway resistance, bronchodilator effect)

Question 14

when is neuromuscular blocking agents given?

Answer 14

during intubation

Question 15

why are LABAs, leukotriene modifiers, and theophylline not given?

Answer 15

Not effective for acute severe asthma attacks

Question 16

when do you seek emergency care?

Answer 16

Severe shortness of breath, unable to speak
Cyanosis (blue lips, face, nails)
No relief after using SABA (albuterol) multiple times
Silent chest (no breath sounds)
Extreme fatigue, drowsiness, confusion
Hypotension, bradycardia (shock symptoms)