Lightning Learning: Life-Threatening Asthma
What?
If a patient has features of acute severe asthma any of the following are present treat as life-threatening:
PEF < 33% best or predicted
SpO2 < 92%
PaO2 < 8 kPa
Normal PaCO2 (4.6-6.0 kPa)
Silent chest
Cyanosis
Poor respiratory effort
Exhaustion
Altered Conscious level
Hypotension
Near Fatal:
Raised PaCO2
Requiring mechanical ventilation
Why?
Asthma is a life changing disease.
In the UK about 3 people a day die as a consequence of asthma.
Being able to recognise and treat acute asthma exacerbations can save lives.
Any patient that presents to ED with features of life-threatening asthma needs to be managed in the Emergency Room.
Regular nebulisers and early steroid treatment are key to managing these patients.
Review them after each intervention and think about what your next treatment will be.
Some patients need intravenous salbutamol and magnesium.
Further Reading
- BTS & SIGN: British guideline on the management of asthma
- University Hospitals of Leicester: ED asthma proforma
- #EM3: Adult asthma simblog & Paediatric asthma simblog