Asthma (Acute)

Question 1

Signs/ symptoms of moderate acute asthma?

Answer 1

PEF of >50-70% best or predicted
No signs of severe acute asthma
Increase in symptoms

Question 2

Signs/ symptoms of severe acute ashtma?

Answer 2

PEF >33-50% of best or predicted
RR >25/min
HR >110bpm
Inability to complete sentences in one breath

Question 3

Signs/symptoms of life-threatening asthma?

Answer 3

SaO2< 92%
Normal PaCO2
Cyanosis
Arrythmias
Exhaustion
Altered concious level
Hypotension
Silent chest
Poor respiratory effort

Question 4

Signs/ symptoms of near fatal asthma?

Answer 4

Increased PaCO2 and/or
requiring mechanical ventilation with raised inflation pressures

Question 5

Type of oxygen used in children for an acute exacerbation of asthma?

Answer 5

High-flow oxygen

Question 6

Recommended range of O2 sats for asthmatics recieving oxygen for acute exacerbation

Answer 6

94-98%

Question 7

Treatment for moderate acute asthma

Answer 7

High-dose SABA via pMDI and large volume spacer.
1 puff every 60 seconds, up to 10 puffs. This can then be repeated after 10 minutes.
40mg oral prednisolone for 5 days

Question 8

Treatment for acute severe asthma

Answer 8

High-dose salbutamol nebs and Ipratropium nebs. (Can be repeated every 20-30 minutes)
40mg oral prednisolone for 5 days

Question 9

Dose of salbutamol nebs for children aged 2-5 years

Answer 9

2.5mg

Question 10

Dose of salbutamol nebs for aged >5 years

Answer 10

5mg

Question 11

Dose of Ipratopium nebs for those aged 2-12

Answer 11

0.25mg

Question 12

Dose of Ipratopium nebs for those aged >12 years

Answer 12

0.5mg

Question 13

When should a patient be reviewed after an acute exacerbation managed at home?

Answer 13

After 2 working days

Question 14

Management of a moderate, acute exacerbation that can be managed at home when the patient is on AIR/MART therapy?

Answer 14

Continue usual maintenance dose (MART) and increase reliever dose to maximum number of puffs daily.

Question 15

Management of a moderate, acute exacerbation that can be managed at home when the patient is on low-dose ICS maintenance therapy and reliever seperately?

Answer 15

Consider quadrupling ICS dose to maximum daily dose for 7 days

Question 16

When should 999 be rang when pastient is on MART/AIR therapy?

Answer 16

If requiring every 1-3 minutes up to 6 puffs, and symptoms are not controlled

Question 17

What age should an acute exacerbation of asthma be managed in hospital?

Answer 17

<2 years old

Question 18

What should be used to adminsiter Salbutamol pMDI in an acute exacerbation if child <?3 years old?

Answer 18

Spacer with close-fitting mask

Question 19

What device should be used to administer salbutamol during an acute exacerbation of asthma <6 years old

Answer 19

pMDI or nebuliser solution (not DPI)