41yr old male is brought to Resus by paramedics with the history of worsening SOB for last 6 hours.He has had flu symptoms for last 2 days. No chest pain, fever or cough is reported.
— PMH: Asthma

Physiology

A – Clear & self maintaining. Unable to complete sentence

B – Rate 35, SpO2 88%. Room air

C – Pulse 130, BP 110/65.  No Chest pain

D – E4 V5 M6 pupils equal

E – Temp 36.9°C


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Why We Simulated

The best strategy for management of acute exacerbations of asthma is early recognition and intervention, before attacks become severe and potentially life-threatening. 

Detailed investigations into the circumstances surrounding fatal asthma have frequently revealed failures on the part of both patients and clinicians to recognise the severity of the disease and to intensify treatment appropriately (UpToDate®).


Learning Points

  1. Use “Pre-Alert Time” to prepare. THINK: Staff, Equipment, Drugs, Protocols, What if…

  2. Familiarise yourself with how to access guidelines/protocols in an emergency.

  3. Remember to “close the loop” on communications to ensure tasks are carried out.

  4. BTS/SIGN guideline on management of asthma.

Positive Feedback

  • Recognised acute asthma and gave bronchodilators.

  • Asked for senior help early.

  • Early recognition of a deteriorating patient.

Edit & Peer Review by Rebecca Prest

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