Asthma

Question 1

2 key concepts of ASTHMA

What if asthma occurs due to anaphylaxis?/

Answer 1

1. Relief of bronchospasm with bronchodilators
2. Relief of inflammation with steroids

Early Adrenaline is indicated.

Question 2

When is prednisolone indicated in Asthma

Answer 2

In MODERATE and SEVERE cases, if no oral steroids in past 24 hours.

Question 3

Treatment in mild to moderate Asthma

Answer 3

MDI
salbutamol 1200microg
Iprotropium 168microg

repeat 20 mins

Oxygen if required.

Prednisolone if moderate 50mg Oral

Question 4

Treatment in Moderate to Severe Asthma

Answer 4

Early clinical support if severe

NEB
5mg Salbutamol - 15mg if severe
500Microg Ipratropium max 3 doses

Oxygen 8Lt

Repeat every 20 mins

Prednisolone 50mg Oral

Question 5

mild asthma define
Speech
Spo2
Wheeze
Hr
Accessory
Cyanosis

Answer 5

Speaking sentences
conscious 
Spo2 > 95
No wheeze - maybe slight expiratory
normal HR
No accessory use
no cyanosis

Question 6

Asthma and iprotropium

how many doses

Answer 6

Max 3 doses in all severities

Question 7

Moderate asthma define

Speech
Spo2
Wheeze
Hr
Accessory
Cyanosis

Answer 7

Phrases
concious
Spo2 92 - 95%
Exp wheeze - maybe insp wheeze
Tachypnea
Tachycardia
Mild accessory use
no cyanosis

Question 8

Severe Asthma define

Speech
Spo2
Wheeze
Hr
Accessory
Cyanosis

Answer 8

Words
Agitated/ distressed
Spo2 90-94%
Wheezes - maybe - poor predictor given resp distress
Tachypnoea
Tachycardia
Moderate Accessory use
Central cyanosis
Unable to lie down - Hyperinflated - Pursed lip breathing

Question 9

Life Threatening Asthma define

Speech
Spo2
Wheeze
Hr
Accessory
Cyanosis \ lungs presentation

Answer 9

Early clinical support

Unable to speak
Drowsey or collapsed
Spo2 <90%
Wheeze - maybe - poor predictor given resp distress
Poor resp effort due to fatigue
Tachycardic or maybe pre-arrest Brady
Severe accessory use or minimal if tiring
Cyanosed
Unable to lie down - Hyperinflated - Pursed lip breathing

Question 10

Treatment in Life Threatening Asthma

Answer 10

Early clinical support

Posture and oxygenation
Continuous nebs - Max 3 ipratropium
IV saline bolus for obstructive shock 500ml bolus
IM adrenaline 10microg/ kg max 500microg
- repeat 5 mins

Question 11

IPPV patients

Answer 11

Early clinical support

Slow inspiration with bag
Extended Expiration times
Continuous inline NEB
Fluid 500ml Bolus - Can give if already given in life threat.
IM adrenaline 10microg/kg MAX 500microg
 - repeat 5 mins

Question 12

Asthma and the ICP

Answer 12

Magnesium
hydrocortisone
intubation

Question 13

Define asthma

Answer 13

Breathing difficulties defined by hyperinflation, inflammation or bronchoconstriction