Asthma

Flussdiagrammknoten

• Asthma

• Reversible chronic inflammatory disease

• Ige antibody exposure

• Mast cell degranulation

• Inflammatory and chemical mediators releaded

• Histamines, neutrophils, macrophages etc.

• Brochospasm

• ↑ Vascular permeability

• Mucosal plugging

• Mucosal oedema

• Mx

• Severe -Agitated/distressed -Marked ↑WoB -Tachycardia -Speaking in words

• Mild/Moderate -Normal C.S -Some ↑WoB -Tachycardia -Speaking in sentences

• Critical -ALOC      -Maximal WoB -Marked tachycardia -Unable to talk

• Salbutamol: pMDI                      - ≥6yrs 4-12 doses - <6yrs 2-6 doses Nebulised    -Small child 2.5mg (1.25mL)    -Medium child 2.5-5mg (1.25-2.5mL)          -Large child     5mg (2.5mL)     Rpt @ 20/60 if rqd

• Salbutamol: Nebulised             -Small child          2.5mg (1.25mL) -Medium child  2.5-5mg (1.25-2.5mL) -Large child             5mg (2.5mL)           Rpt @ 20/60 if rqd Ipatropium Bromide: Nebulised        -250mcg (1mL) once

• Salbutamol: Nebulised         -All ages        10mg (5mL)      Rpt @ 5/60 if rqd Ipatropium Bromide: Nebulised        -250mcg (1mL) once Adrenaline: -10mcg/kg IM   Rpt @5-10/60 rqd Max 30mg/kg

• No signif response after 20/60 = Rx as severe