Asthma

Question 1

What is Asthma?

Answer 1

Asthma is a respiratory condition that causes inflammation of the airways, which results in narrowing of the airways

Question 2

Mild/Moderate Asthma Signs and Symptoms

Answer 2

• Speak in whole sentences
• SpO2% >94%
• Pulse <100bpm
• PEFR >75% of predicted adult and >60% of paed predicted

Question 3

Severe Asthma Signs and Symptoms

Answer 3

• Use of accessory muscles or tracheal tug
• Unable to speak full sentence in one breath
• Obvious respiratory distress
• SpO2% 90-94%
• Pulse 100-120/min adult and 100-200/min Paed
• PEFR 50-75% adult and PEFR 40-60% Paed

Question 4

Life Threatening Asthma Signs and Symptoms

Answer 4

• Reduced consciousness or collapse
• Exhaustion/agitation
• Cyanosis
• SpO2% <90% on room air
• Poor respiratory effort - soft/absent breath sounds
• Talks in words
• Pulse >120 adults >200 in paeds (paeds will be bradycardic if respiratory arrest imminent)
• PEFR <50% adult and <40% paed

Question 5

Mild/Moderate Asthma Treatment

Answer 5

• Salbutamol

- If unsuccessful after 1 nebule, move to severe treatment plan

Question 6

Severe Asthma Treatment

Answer 6

• Salbutamol
• Ipratropium Bromide
• Hydrocortisone
• Continue to monitor and look for response to treatment

Question 7

Life Threatening Asthma Treatment

Answer 7

• Adrenaline
• Salbutamol
• Ipratropium Bromide
• Hydrocortisone
• Continually reassess

Question 8

Life Threatening Asthma Doses for Adults

Answer 8

• Salbutamol: 5mg Neb, no maximum, repeat while indicated
• Ipratropium Bromide: 500mcg Neb, 1mg maximum
• Hydrocortisone: 100mg/2mL IM/IV, no repeat
• Adrenaline: 500mcg 1in1000 IM, nil max, repeat every 5min. If 4 IM doses unsuccessful, consider ICP for IV adrenaline