CCS ASTHMA

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  • HPI 5yo child with acute asthmatic attack

Note[edit | edit source]

  • vital signs: BP, Pulse, Resp. Rate, Temp.
  • Step I : Emergent management: A, B, C, D- O2 , broncodilaters MDI or nebulizer, depending on severity consider systemic corticosteroids.
  • Step II : Physical Examination General appearance, HEET/Neck, Chest/Lung, Heart/CV

Investigations[edit | edit source]

  • Step III : Diagnostic Investigations:
  • 1. O2 sat.2
  • . PEF
  • 3. CBC
  • 4. Chem 7
  • 5. CXR
  • 6. ABG- should be considered in severe distress of when FEV1 <30% of predicted values after initial treatment.

Treatment[edit | edit source]

1. O22. Beta 2 agonist with MDI or Nebulizer every 20 mins 3. methylprednisolone IV q6h for first 24-48 hours then inhaled steroids Step IV: Decision about changing patients location Discharge home if symptoms resolve quickly or FEV1 is greater than 70% of predicted or personal best.

Recommendations for hospitalization[edit | edit source]

  • 1. response to treatment is poor
  • 2. recent hospitalization for asthma
  • 3. failure of aggressive outpatient management
  • 4. previous life- threatening attack.
  • 5. If PEF or FEV1 is less than 50%
  • 6. arterial carbon dioxide tension is greater than 42
  • 7. If patient is confused of drowsy8. If no easy access to ER

If patient is discharge need to return to office within 5-7 days for follow up. Step V: Educate patient and family:Instruct patient/family to avoid factors that aggravate patients disease.Instruct on proper use of MDI

Diagnosis[edit | edit source]

STEP VI: Final Diagnosis.Acute asthma attack

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Contributors: Prab R. Tumpati, MD