Severe Asthma Exacerbation
Signs of a Severe Asthma Exacerbation:
• Vitals: ↑HR ↑RR ↓SpO2
• High work of breathing / accessory muscle use
• Inability to speak in full sentences
• Diffuse wheezing OR poor air flow
• ABG:
- High pCO2 / low pH
- Abnormally normal ABG with increased work of breathing
• Peak flow
- < 200 L/ min or
- ≤ 50% of baseline
Treatments for Severe Asthma:
• Nebulized Bronchodilators: Albuterol, Ipratropium
• Adjunctive therapies: IV Mg, Heliox, Ketamine, IV beta agonists
• Glucocorticoids: Methylprednisolone, Prednisone
• NIPPV: BiPAP, Brief trial
Mechanical Ventilation in Asthma:
• Volume control mode of ventilation
• Initial ventilator settings
• Manage Ventilator Dyssynchrony
• Monitor for Improvement
By @PulmPEEPs
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