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Feedback Pulmonology

Asthma Attack – severity, clinical course, complications, treatment

  • Patients with acute severe asthma have
    • Inability to complete a sentence in one breath
    • Respiratory rate  >25 breaths per min
    • Tachycardia >110bpm
    • PEFR <50% of predicted
  • Features of life-threatening attacks are
    • Silent chest, cyanosis
    • Exhaustion, confusion, coma
    • Bradycardia or hypotension
    • PEFR <30%
  • Always measure ABGs when asthmatic patient is admitted to hospital
  • Pulse oximetry to monitor oxygen saturation
  • Features of a very severe life-threatening attack
    • High PaCO2 >6kPa
    • Severe hypoxemia despite treatment with oxygen <8kPa
    • Low/falling arterial pH

Management

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