Flashcards in 1 - Paeds - Resp - Asthma - Ix, DDx, Acute Exacerbation, Stages Deck (12):
Usually Ix? why do Ix?
usually diagnosed from Hx and Ex and requires no Ix
done to confirm/explore severity/phenotype
what Ix are done?
skin prick test for allergens
response to treatment
viral induced wheezing (common, ~1/2 of<3's, resolves ~5y) bronchiolitis, croup
Acute exacerbation of asthma - what to note on presentation?
duration of sx, treatment already given, course of previous attacks
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
late signs of acute exacerbation of asthma
what to assess
cyanosis, fatigue, drowsiness, silent chest (emergency, resp arrest)
assess PEFR and sats
moderate severity - O2?, PEFR? clin feat?
O2 >92%, PEFR >50% , no clin features of severe asthma
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
severe attack - O2? PEFR? Clin feat?
O2 <92%, PEFR <50%
tachypnoea, tachycardia, acc mm use, too SOB to talk/feed
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
Life threatening attack - O2? PEFR? clin signs?
silent chest, poor resp effort, altered consciousness, cyanosis, O2<92% PEFR <33%