Asthma

Key signs of life-threatening asthma

  • Cyanosis or respiratory rate <8 per minute
  • Bradycardia (heart rate <50 per minute)
  • Exhaustion, confusion, decreased conscious level

Key signs of acute severe asthma

  • Inability to complete sentences in one breath
  • Respiratory rate >25 per minute
  • Tachycardia (heart rate >110 per minute)

Management

The priority is to transfer patients displaying symptoms of life-threatening asthma to hospital immediately as an emergency.

  • Assess the patient.
  • Sit patient upright.

Administer 100% oxygen

Flow rate: 15 litres/minute.

As for adults

For adults:

Administer 100% oxygen

Flow rate: 15 litres/minute.

For children:

As for adults


Administer the patient’s own bronchodilator (2 puffs); if unavailable, administer a salbutamol inhaler, 4 puffs (100 micrograms per actuation), through a large-volume spacer, repeat as needed.

Salbutamol inhaler

2–17 years

1 puff via a spacer every 15 seconds (max. 10 puffs), repeat above regime at 10 – 20 minute intervals as needed.

For adults:

Administer the patient’s own bronchodilator (2 puffs); if unavailable, administer a salbutamol inhaler, 4 puffs (100 micrograms per actuation), through a large-volume spacer, repeat as needed.

For children:

Salbutamol inhaler

2–17 years

1 puff via a spacer every 15 seconds (max. 10 puffs), repeat above regime at 10 – 20 minute intervals as needed.

If a patient suffering from a severe episode of asthma does not respond to treatment with bronchodilators within 5 minutes of administration, they should also be transferred to hospital as an emergency.