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Flashcards in Acute asthma Deck (16):
1

What can cause airway compromise in patients?

Secretions

2

What signs would be associated with potential airway compromise?

See-saw breathing
Use of accessory muscles
Diminished breath sounds
Added sounds
Cyanosis

3

What might be heard when auscultating a patients chest with acute asthma?

Reduced air entry
Wheeze - becomes less apparent with increasing obstruction

4

How much oxygen should be used?

15L through a non-rebreather

5

What drug is used as a first line agent in asthma?

Beta-2-agonists

6

How often should nebulised salbutamol be given in an acute, severe, asthma attack? And at what dose?

When required or every 20-30mins
5mg

7

What dose of steroids should be given PO in acute asthma?

40-50mg prednisolone

8

If the oral route is not available to give steroids, what route and agent should be used?

IV hydrocortisone
(100mg every 6 hours)

9

Other than salbutamol, what other nebulised drug should be started initially?

Ipratropium Bromide (0.5mg 4-6hourly)

10

What circulatory interventions should be performed?

IV access
Bloods

11

What bloods should be taken?

FBC
U&E
LFT
Clotting
CRP

12

What other drugs can be used in the treatment of acute asthma (not salbutamol/steroids/ipratropium)

IV Magnesium sulphate
IV aminophylline

13

What is the typical ABG picture in acute asthma?

pH - alkalosis often present due to hyperventilation
PaCO2 - often low due to hyperventilation
PaO2 - may be low

14

What criteria would suggest a moderate asthma exacerbation?

Increasing asthma symptoms. PEFR >50-70% of best or predicted.
No features of severe asthma.

15

What criteria would suggest a severe asthma exacerbation?

PEFR 33-50% of best or predicted
Respiratory rate greater or equal to 25 breaths/min
Pulse greater or equal to 110 beats/min
Inability to complete sentences in one breath

16

What criteria would suggest a life-threatening asthma exacerbation?

PEFR <33% of best or predicted
Oxygen saturation <92%
Silent chest
Cyanosis
Poor respiratory effort
Bradycardia
Hypotension
Dysrhythmia
Confusion
Exhaustion
Coma