Flashcards in 2.1 Asthma Deck (41)
What are the signs of Asthma?
Hint - BOP
Plugging (mucus in small airways)
What do you give asthma patients in the way of a bronchodilator?
5mg salbutamol and 0.5mg ipratropium - Nebulised
What status must an asthma patient be to recieve IM adrenaline?
Status 2 and not rapidly improving
How often can IM adrenaline be repeated?
Every 10 minutes if IV access is not obtained.
What would be a sign to you that the patient has mild to moderate asthma with regards to breathing examination?
Short of breath
able to speak sentences
no significant chest or neck indrawing
If an asthma patient is not making any noise as they breath eg a wheeze what is your priority treatment?
If a child is aged less than 1 year and short of breath and wheezy - what would they usually have?
Why would children under 1 year not have asthma?
Because they have;
poorly developed bronchial smooth muscle
fewer beta 2 receptors than adults
Would bronchodilators have a place in treating a child with bronchiolitis?
No significant role and should be rarely used.
Focus should be on treatment for hypoxia.
There is a risk of exacerbating asthma in small children if IV access is attempted through stress - do you need to weigh this up in risk assessment?
Yes : don't IV unless need to.
If a child has recieved IM adrenaline, do they need IV access?
How effective are spacers in the treatment of asthma?
Very effective in the majority of patients.
If a spacer is visibly cloudy/dirty is it still effective?
Not as effective
What should you consider doing if a spacer is dirty, but they have a management plan in place to use this in mild to moderate asthma attacks?
Consider nebulised bronchodilators from ambulance.
Can you give bronchodilators if a patient has a wheeze as a result of smoke or toxic gas inhalation?
When should you consider reducing the dose of salbutamol and ipratropium for patients?
If they are small
has ischaemic heart disease
What is the preferred site for IM Adrenaline administration?
If not available use lateral arm
Why do you give IM drugs in the lateral thigh muscle?
What is a side effect of adrenaline?
What should you suspect if a patient has a wheeze, but no history of asthma or CORD and they are over 60?
Cardiogenic Pulmonary Odema
Is asthma a rapid or slow onset?
Can a patient who has asthma also have a cough?
True or false - Patients with asthma are usually hypotensive and vaso constricted?
Blood pressure is usually normal
normal cap refill
What diagnosis would you give if a patient has wheeze or crackles that are unilateral and limited to one lung lobe/are only?
A chest infection
Can a patient have asthma and cardiogenic pulmonary odema?
What is dynamic hyperinflation?
An increase in the amount of gas within the lungs due to bronchoconstriction.
Why does dynamic hyperinflation occur?
Because the resistance to gas leaving the lungs during expiration is higher than the resistance to gas entering the lungs during inspiration.
Can dynamic hyperinflation cause a Pneumothorax?
What is a common result of dynamic hyperinflation with regards to the cardiovascular system?
Reduced veinous return to the heart.
Due to increased intra-thoracic pressure.