Assessment of acute asthma (Medical students)
Assessment
History
Too breathless to eat or talk?
Response to reliever?
Previous admission?
Clinical
General condition and consciousness
Cyanosis
HR, RR, BP
Recessions and accessory muscles
Auscultation - air entry, diffuse wheeze
Measurements
PEFR
Pulse oximetry
Venous gases (if iv cannula for hydrocortisone)
Classification
Acute Severe
SpO2 less than 92%
PEF 33-50% best/predicted
Can’t complete sentences in one breath or too breathless to talk or feed
Tachycardia: above 125 (more than 5 years) or above 140 (2 to 5 years)
Tachypnoea: above 30 breaths/min (more than 5 years) or above 40 (2 to 5 years)
Life Threatening
SpO2 less than 92%
PEF less 33% best/predicted
Confusion
Exhaustion
Poor respiratory effort
Silent chest
Cyanosis
Hypotension
Coma
Initial Treatment
History
Too breathless to eat or talk?
Response to reliever?
Previous admission?
Clinical
General condition and consciousness
Cyanosis
HR, RR, BP
Recessions and accessory muscles
Auscultation - air entry, diffuse wheeze
Measurements
PEFR
Pulse oximetry
Venous gases (if iv cannula for hydrocortisone)
Classification
Acute Severe
SpO2 less than 92%
PEF 33-50% best/predicted
Can’t complete sentences in one breath or too breathless to talk or feed
Tachycardia: above 125 (more than 5 years) or above 140 (2 to 5 years)
Tachypnoea: above 30 breaths/min (more than 5 years) or above 40 (2 to 5 years)
Life Threatening
SpO2 less than 92%
PEF less 33% best/predicted
Confusion
Exhaustion
Poor respiratory effort
Silent chest
Cyanosis
Hypotension
Coma
Initial Treatment
- Oxygen
- Nebulized salbutamol, ipratropium
- Steroids