Asthma in kids is common… very common. So we should know how to manage it in our Emergency Departments. Occasionally we see a child with severe or critical asthma; when this happens it is useful to know what your plan is – a plan you can make beforehand, rather than in the heat of the moment…
Join us for this PEMcast as we navigate the current conventional wisdom on management of acute asthma, including what to do when things are not going as well as you would have liked…
Outline of this podcast: Asthma
CP: welcome, disclaimer
CP: intro (not discussing diagnostic controversies in infants & toddlers)
SF: definition (recurrent reversible wheeze?)
KB: incidence (worldwide vs WA – seems high in Perth)
CP: chronic stable asthma assessment & management
SF: assessment of acute asthma attack – overview (Asthma Management Handbook pg 43-46 – table 5)
KB: signs of severe / critical asthma
CP: put into context of treatment prior to attending ED
SF: management of mild & moderate: salbutamol (=albuterol), review response (is fall in SpO2 always bad?), decide disposition
CP/all: why spacers, not nebs?
All: Who should get steroids? What dose? How long? (controversy of steroids in under 5′s to be discussed another time)
KB: treatment options in severe / critical asthma (Atrovent, IV salbutamol, aminophylline, magnesium, mechanical ventilation)
All: any advantage of Adrenaline (=epinephrine) neb, IM or IV)?
CP: Non-Invasive Ventilation vs Intubation & IPPV (risks/complications)
All: Options for intubating drugs (midazolam, fentanyl, thiopentone, propofol, ketamine, muscle relaxant)
SF: Initial ventilator settings
CP/all: Resources (NAC, RCH asthma action plan generator), Summary, goodbye for now
