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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