Lightning Learning: Life-Threatening Asthma

“Asthma is a life-changing disease and (in the UK) about 3 people a day die as a consequence.”

— advice is based on local guidelines & procedures

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What?

If a patient has features of acute severe asthma any of the following are present treat as life-threatening:

1. PEF < 33% best or predicted

2. SpO2 < 92%

3. PaO2 < 8 kPa

4. Normal PaCO2 (4.6-6.0 kPa)

5. Silent chest

6. Cyanosis

7. Poor respiratory effort

8. Exhaustion

9. Altered Conscious level

10. Hypotension

Near Fatal:

1. Raised PaCO2

2. 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