1 - Paeds - Resp - Asthma - Ix, DDx, Acute Exacerbation, Stages Flashcards Preview

CP2 > 1 - Paeds - Resp - Asthma - Ix, DDx, Acute Exacerbation, Stages > Flashcards

Flashcards in 1 - Paeds - Resp - Asthma - Ix, DDx, Acute Exacerbation, Stages Deck (12):
1

Usually Ix? why do Ix?

usually diagnosed from Hx and Ex and requires no Ix
done to confirm/explore severity/phenotype

2

what Ix are done?

skin prick test for allergens
CXR (normal)
PEFR (variable)
response to treatment

3

DDx??

GORD
CF
viral induced wheezing (common, ~1/2 of<3's, resolves ~5y) bronchiolitis, croup

4

Acute exacerbation of asthma - what to note on presentation?

duration of sx, treatment already given, course of previous attacks

5

Features of an acute attack? 7 things

wheeze and tachypnoea (2-5y - >50/min, >5y - >30/min)
-tachycardia (>130/m in 2-5y, >120 in >5y)
-use of acc mm, and chest recession
-marked pulsus paradoxus
-SOB interferes with talking

6

late signs of acute exacerbation of asthma

what to assess

cyanosis, fatigue, drowsiness, silent chest (emergency, resp arrest)

assess PEFR and sats

7

moderate severity - O2?, PEFR? clin feat?

O2 >92%, PEFR >50% , no clin features of severe asthma

8

moderate severity - mgmt?

SABA via spacer 2-4 puffs, increase by 2 puffs every 2 min up to 10 as required, consider oral pred, reassess 1hr

9

severe attack - O2? PEFR? Clin feat?

O2 <92%, PEFR <50%
tachypnoea, tachycardia, acc mm use, too SOB to talk/feed

10

severe attacks - mgmt?

O2 via face mask to increase sats, SABA neb or via spacer 10 puffs. Oral pred or IV hydrocortisone.
poor response/ neb ipratropium bromide, repeat SABA every 20-30mins PRN

11

Life threatening attack - O2? PEFR? clin signs?

silent chest, poor resp effort, altered consciousness, cyanosis, O2<92% PEFR <33%

12

life threatening - mgmt

O2 face mask, Neb SABA plus ipratropium bromide, IV hydrocortisone, contact senior, PICU, Paeds, repeat SABA every 20 mins

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