acute exarcebation of ronchial asthma

Send This

Download

Comment

Favourite

more

Rating :

Rate It:

Embed :

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

4 Favorites

tulika.tuli007, favourited this 1 Years ago.

scorpiosu89, favourited this 1 Years ago.

renubasent, favourited this 1 Years ago.

tulikaMj4, favourited this 1 Years ago.

First Prev [1] Next Last

Notes

Hide Notes

Slide 1 :

Guideline management in observation ward Acute exarcebation of bronchial asthma Dr Nor Amilah Bt Mohd Ramli

Slide 2 :

DEFINITION Asthma, irrespective of severity, is a chronic inflammatory disorder of the airways. In susceptible individuals, this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness and cough particularly at night and in the early morning. These episodes are usually associated with widespread but variable airflow obstruction Often reversible either spontaneously or with treatment.

Slide 3 :

DIAGNOSING ASTHMA

Slide 4 :

MANAGEMENT The aims of management are: • To prevent death • To relieve symptoms • To restore the patient’s lung function to the best possible level as soon as possible • To prevent early relapse

Slide 5 :

Assesment criteria

Slide 6 :

Slide 7 :

SUBSEQUENT MANAGEMENT IN THE WARD Continue oxygen Intravenous hydrocortisone 100-200 mg 6 hourly or prednisolone 30-60 mg daily • Nebulised beta2-agonist 2-4 hourly preferably in combination with anticholinergic (it may be necessary to give nebulised beta2-agonist more frequently up to every 15 minutes) Terbutaline or salbutamol infusion at 3-20 mcg/ min after an initial intravenous bolus dose of 250 mcg over 10 minutes can be given as an alternative • If patient is still not improving, commence aminophylline infusion (0.5-0.9 mg/kg/hour); monitor blood levels if aminophylline infusion is continued for more than 24 hours. • In cases where response to the above treatment is inadequate, intravenous magnesium sulphate 2 g in 50 ml normal saline infused over 10-20 minutes may be given

Slide 8 :

Monitoring the response to treatment - repeat measurement of PEF 15-30 minutes after starting treatment - aim to maintain arterial oxygen saturation above 95% - repeat arterial blood gas measurements if initial results are abnormal or if patient deteriorate - monitor PEF at least 4 times daily throughout the hospital stay

Slide 9 :

Transfer patient to the intensive care unit or prepare to intubate if there is: - deteriorating PEF - worsening hypoxaemia, or hypercapnia - exhaustion or feeble respiration - confusion or drowsiness - coma or respiratory arrest

Slide 10 :

Before discharge: • give prednisolone 30-60 mg daily for 7-14 days, plus regular inhaled steroids and inhaled beta2-agonist to be taken as needed • review adequacy of usual treatment and step up if necessary • ensure patient has enough supply of medications • check inhaler technique and correct if faulty • arrange for follow-up within 2 weeks • advise patients to return immediately if asthma worsens

Slide 11 :

Thank you…

Acute Coronary Syndr...

Managing Asthma Asth...

Acute Hepatitis B Wh...

Acute Coronary Syndr...

Acute Diarrhea and E...

Acute Myocardial Inf...

Free Powerpoint Templates

	dr.amilah 11 Months ago.



509 Views, 4 favourite
PowerPoint Presentation on acute exarcebation of ronchial asthma
More By User Flag as inappropriate Select your reason for flagging this presentation as inappropriate. If needed, use the feedback form to let us know more details. Cancel