Asthma

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