Asthma exacerbation resident survival guide: Difference between revisions
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{{Family tree | | | | | F01 | | F02 | | F03 |-|-|-|'| | | | | | | | | | |F01=Discharge|F02=Admit to ward|F03=Admit to ICU }} | {{Family tree | | | | | F01 | | F02 | | F03 |-|-|-|'| | | | | | | | | | |F01=Discharge|F02=Admit to ward|F03=Admit to ICU }} | ||
{{Family tree | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | |}} | {{Family tree | | | | | | | | | | | | | |!| | | | | | | | | | | | | | | |}} | ||
{{Family tree | | | | | | | | | | | | | G03 | | | | | | | | | | | | | | |G03=Intubation<br>&ventilation<br>IV Corticosteroids<br>SABA}} | {{Family tree | | | | | | | | | | | | | G03 | | | | | | | | | | | | | | |G03=Intubation<br>&ventilation<br>IV Corticosteroids<br>SABA<ref>National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 Aug. Section 5, Managing Exacerbations of Asthma.Available from: http://www.ncbi.nlm.nih.gov/books/NBK7228/</ref>}} | ||
{{Family tree/end}} | {{Family tree/end}} | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 18:12, 3 December 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]
Causes
Life threatening causes
Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated
common causes
Management
| Dyspnea Cough Wheezing Chest tightness | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Initial assessment H&P O2 sat Spirometry Initial management O2 SABA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Moderate exacerbation FEV1/PEF 40-60% dyspnea with daily activities | Severe exacerbation FEV1/PEF<40% Dyspnea at rest | Respiratory arrest Intubation & mechanical ventilation 100%O2 SABA & Ipratropium IV corticosteroids | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| O2(target>90%sat) Inhaled SABA every 60mins PO corticosteroids | O2(>90%sat) SABA+Ipratropium continuous PO corticosteroids consider adjunct therapy | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Good response FEV1/PEF>70% No distress Stable after 60 mins of Rx Normal H&P | Incomplete response FEV1/PEF 40-60% Mild-mod symptoms | Poor response FEV1/PEF<40% PCO2≥42 mm Hg Confusion and severe symptoms | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Discharge | Admit to ward | Admit to ICU | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Intubation &ventilation IV Corticosteroids SABA[1] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ National Asthma Education and Prevention Program, Third Expert Panel on the Diagnosis and Management of Asthma. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Bethesda (MD): National Heart, Lung, and Blood Institute (US); 2007 Aug. Section 5, Managing Exacerbations of Asthma.Available from: http://www.ncbi.nlm.nih.gov/books/NBK7228/