Respiratory disorders and their management II Flashcards Preview

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Flashcards in Respiratory disorders and their management II Deck (10)
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1

Asthma prevalence?

5.4 million UK
1 in 12 adults, 1 in 11 child

2

Anxious pt, becomes SOB, uses blue inhaler but isn't making a difference.
What history would you do?

Duration of onset of symptoms
Any infective features/triggers - dust, pets, anxiety
Severity of illness - previous hospital admissions
Other meds

3

Anxious pt, becomes SOB, uses blue inhaler but isn't making a difference.
What signs will be seen on examination?

What bedside tests can you do to measure the severity?

Elevated resp rate
Inability to complete sentences
Peripheral/central cyanosis
Audible wheeze
Tachycardia

Measure HR, resp rate, peak flow meter

4

Symptoms of asthma?

Wheeze
Cough
Chest tightness
Dyspnea
Nocturnal duration
Possible triggers - exertion, dust, temp change, emotional status, occupation

5

Signs of asthma?

Eczema
Nasal polyps
Cushingoid
Wheeze
Exacerbation - assess RR, HR, SpO2, ability to speak

6

How to diagnose asthma?

Measure their peak flow - see if there's a fluctuation of 20% = asthmatic
Suspected asthma = Trail of inhaled steroids (beta agonists) = if works = diagnose asthma

7

How to deliver inhaled drugs?

Meter dose inhaler (SABA/LABA/Ipatropium/ICS
MDI via spacer (4 puffs initially then 2 puffs every 2 mins up to max 10 puffs)
Breath actuated inhalers e.g. turbohaler

8

Pts at risk of near fatal or fatal asthma?

Not taking treatment
Not going to GP
Previous near fatal asthma
Heavy use of beta agonist
Self discharge from hospital
Obesity
Denial
Alcohol or drug abuse
Income problems

9

Acute asthma severity - what to measure?

- Mild - PEF best 75+
- Moderate - PEF best 50-75
- Severe PEF best 33-49, resp rate >25/min, HR >110/min, no talking
LT PEF best <33, HR bradycardia, SaO2<92, silent chest

10

What to do in an asthmatic emergency?

Beta agonists
Steroids asap
Anticholinergics with beta agonists