wheezy chest Flashcards
all wheezes denote ?
some form of obstruction
whats the difference between intra-thoracic and extra-thoracic wheeze ?
intra thoracic- limits expiration
extra thoracic- limits inspiration
what is stridor ?
high pitched sound due to obstruction at the level of the supra glottis
glottis
or trachea
what is rhonchi and what sound does it resemble ?
obstruction and/or secretions in larger airway and it resembles snoring
what is the general approach taken for a wheezy patient ?
history taking
physical examination
spirometry (+ reversibility testing)
bronchial challenge test
radiology
bronchoscopy
what are the common indications to perform ABG ?
cases of hypoxemia SpO2<92%
life threatning asthma
os suspecting another diagnosis DKA
what would be thee initial treatment for a patient presenting with an acute asthma attack ?
b2 agonist , ipatropium bromidee
prednisolone for 5-7 days
what is the role of antibiotics in acute asthma ?
not indicated
what is the criteria for home discharge after a patient presented with an acute exacerbation of bronchial asthma ?
improved symptoms - no need for SABA
PEF improved > 60-80% predicted
SPO2 is above 94% on room air
adequate home resources
what should be arranged for the patient upon discharge ?
reliever to bee continued as needed
start controller
check inhaler technique
prednisolone for 5-7 days
follow up in a week
what is the method of oxygen delivery to be used in type 2 RF ?
give oxygen using a venturi mask
what antibiotics should be used in accute exacerbations of COPD ?
clavulanic acid/ amoxicillin or
macrolide
or tetracycline
what is thee oxygen saturation that should be maintained during acute exaceerbation ?
88-92%
