Flashcards in Asthma Deck (12):
What are the best markers for severity in an acute attack?
What are poor markers?
- Conscious state
- Work of breathing
- Wheeze severity
- Pulsus paradoxus
- Peak expiratory flow
What is the indication for oxygen therapy in asthma?
- Not wheeze or work of breathing
Why might tachycardia not be a good clinical indicator?
It's a side effect of salbutamol
Why isn't SaO2 necessarily a good clinical indicator?
It purely reflects oxygenation
- Doesn't reflect ventilation therefore CO2 retention could be occurring
What does a mild asthma attack look like?
Normal conscious state
Subtle increase or no increase in WOB
What does a moderate asthma attack look like?
Normal mental state
Some increased WOB
Some limitation of ability to talk
What does a severe asthma attack look like?
Marked increase WOB
Marked limitation in talking
What does a critical asthma attack look like?
Unable to talk
+/- Silent chest
How do you escalate therapy for mild to moderate?
Add oral prednisolone (2mg/kg for first day, only continuing at 1mg/kg if there is ongoing need for bronchodilators)
And O2 is sats less than 92%
How do you escalate therapy from moderate to severe?
O2 if not already given
Add ipratropium, aminophylline, and magnesium sulphate
Consider IV pred if vomiting
How do you escalate therapy from severe to critical?
Continuous nebulised salbutamol and ipratropium (consider IV sal)