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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 a salbutamol inhaler, 1 puff (100 µg per actuation) through a large-volume spacer every 30-60 seconds (each dose to be inhaled separately), maximum 10 puffs; repeat as needed.

Salbutamol inhaler

2–17 years

1 puff via a spacer every 30-60 seconds (max. 10 puffs), each dose to be inhaled separately; repeat above regime at 10 – 20 minute intervals as needed.

For adults:

Administer a salbutamol inhaler, 1 puff (100 µg per actuation) through a large-volume spacer every 30-60 seconds (each dose to be inhaled separately), maximum 10 puffs; repeat as needed.

For children:

Salbutamol inhaler

2–17 years

1 puff via a spacer every 30-60 seconds (max. 10 puffs), each dose to be inhaled separately; 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.