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MindMap Gallery Acute Asthma Exacerbation

Acute Asthma Exacerbation

This mind map is about Acute Asthma Exacerbation. Start to use a mind map to express and organize your ideas and knowledge right now.

Edited at 2020-09-28 07:48:53

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Acute Asthma Exacerbation

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Acute Asthma Exacerbation

Clinical Presentation

Minimal no signs or symptoms

No cough

No wheezing

No chest tightness

No shortness of breath at day or night

Able to do all normal activities

Worse signs and symptoms

Cough

Wheezing

Chest tightness

Shortness of Breath

Waking at night with symptoms

Able to do some normal activities

Life threatening signs and symptoms

Very short of breath

Difficult to walk or talk

Blue lips or fingernails

Medications not working

Unable to do activities

Diagnosis

Confirmed by a worsening of symptoms: like wheezing, frequent cough, shortness of breath or chest tightness.

Low Expiratory Flow Rates (i.e. Peak Flow)

Identification of underlying triggers or infection

Respiratory alkalosis and hypoxemia

Respiratory Acidosis is a late diagnosis sign showing impending respiratory failure in acute asthma exacerbations.

Pulsus Paradoxus - a consequence of lung hyperinflation

Tachypnea & Tachycardia

Hypercapnia

Epidemiology

Pros

The death rate from Asthma has been on a steady decline sine 1995.

Asthma is controllable in combination with preventative care and proper treatment.

New pharmacologic treatments provides the ability to better control Asthma.

Cons

Asthma effects as many as one third adolescents in some countries.

Prevalence rate in American is around 4-8%.

Boys are more frequently effected that girls.

Around 26 million people and 7 million children are effected by Asthma in America.

Pathophysiology

Bronchoconstriction in the trachea, bronchi, and bronchioles.

Airway walls dilate and leak secretions, oedema, adding to the overall narrowing and hyper-responsiveness of the airway.

Unmyelinated afferent fibers in combination with peptide neurotransmitters can induce smooth muscle or bronchospasm.

Mast cell degranulation leads to vasoactive mediators increasing vasodilation and capillary permeability while chemotactic mediators increase cellular infiltration with the over-production of neutrophils, eosinophils, and lymphocytes.

An abnormal narrowing and hypersensitive, congested airway.

Outpatient Treatment

Green Zone: Doing Well•No cough, wheeze, chest tightness, or shortness of breath during the day or night •Continue normal activities +Continue long-term control medications daily and any medications needed before activities.---> What is your best peak flow reading?

Yellow Zone: Asthma Is Getting Worse•Cough, wheeze, chest tightness, or shortness of breath, or•Waking at night due to asthma; You can do some but not all normal activities. --->Is Peak Flow between 50-79% of best peak flow? Continue to take all Green Zone medication and add quick relief medication: Short-acting beta2-agonist -->every 20 minutes up to an 1 hour/ two-four puffs. Use Nebulizer if available.If symptoms resolve, return to Green Zone. If they do not continue in Yellow Zone and call MD for possible use of oral steroid in addition to nebulizer and short-acting beta2-agonist.

Red Zone: Medical Alert!•Very short of breath and Quick-relief medicines are not helping.•Cannot do normal activities. •Shortness of breath making it difficult to walk or talk.•Blue lips or fingernails.•In the Yellow Zone for over 24 hours with similar or worse symptoms. ---> Is peak flow less than 50% of your best? **Continue taking medications in Yellow Zone and CALL MD. ***Take 4-6 puffs of quick-acting medications ****Call 911 or go straight to the hospital if symptoms continue past 15 minutes and/or you have not reached your doctor.

Inpatient Treatment

Oxygen

Inhaled short-acting beta 2-agonist intermittently or continuously

Corticosteroids - oral or intravenously

Consider other therapies

Monitor patient closely: SpO2,FEV1, PEF, and vitals.

In extreme cases consider intubation

References

American Lung Association, (2016). Asthma Action Plan. Lung Health & Diseases. Retrieved from http://www.lung.org/assets/documents/asthma/asthma-action-plan.pdf.

American Lung Association, (2016). How is Asthma Diagnosed? Lung Health & Diseases. Retrieved from http://www.lung.org/lung-health-and-diseases/lung-disease lookup/asthma/diagnosing-treating-asthma/how-is-asthma-diagnosed.html

American Lung Association, (2016). Learn about Asthma. Lung Health & Diseases. Retrieved from http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/asthma/learn-about-asthma/

Pollart, S. (2011). Management of Acute Asthma Exacerbations. American Family Physician. 84(1):40-47. Retrieved from http://www.aafp.org/afp/2011/0701/p40.html

Huether, S.E. & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

McPhee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.

Zimbron, J. (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://MedMaps.co.uk