GOOD DAY !
ASTHMA
Managing exacerbations
SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Management of exacerbations in adults
A short (7-10 days) course of oral corticosteroids is the current standard treatment for adults with moderate-to-severe asthma exacerbations.
I
When administering a SABA via MDI during an exacerbation, use a spacer. [√]
In adults with acute exacerbations not considered severe enough for admission to hospital, high-dose ICS may be effective. II
Merely doubling the maintenance ICS dose is not effective in managing exacerbations. II
Management of exacerbations in children
A short (up to 5 days) course of oral corticosteroids (prednisolone 1 mg/kg up to 60 mg daily) is the current standard treatment for severe exacerbations. Closely monitor response to treatment. I
Children who are taking regular preventive medication should continue taking the same dose during an exacerbation. II
When administering a SABA via MDI during an exacerbation, use a spacer. III-1
Merely doubling the maintenance ICS dose is not effective in managing exacerbations in children. II
Saturday 31 January 2009
ASTHMA KEY POINTS
GOOD DAY !
ACUTE ASTHMA
SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Managing acute asthma in adults
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Assess response to treatment using spirometry, oxygen saturation, heart rate, respiratory rate and pulsus paradoxus status.
[√]
Wheeze is an unreliable indicator of the severity of an asthma attack and may be absent in severe asthma.
[√]
Ensure every patient receives adequate follow-up after an acute asthma episode, including review of medications, triggers and asthma action plan.
[√]
Managing acute asthma in children
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Emergency management of acute asthma in a child is based on initial administration of salbutamol 4-6 puffs (< 6 years) or 8-12 puffs (≥6 years) via MDI.
I
Load the spacer with one puff at a time and give each puff separately.
III-1
If treatment with an oral corticosteroid (e.g. prednisolone 1 mg/kg up to 60 mg as a single daily dose) has been initiated for a moderate-to-severe acute episode, continue for up to 5 days.
ACUTE ASTHMA
SUMMARY OF PRACTICE POINTS
LEVEL OF EVIDENCE
Managing acute asthma in adults
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Assess response to treatment using spirometry, oxygen saturation, heart rate, respiratory rate and pulsus paradoxus status.
[√]
Wheeze is an unreliable indicator of the severity of an asthma attack and may be absent in severe asthma.
[√]
Ensure every patient receives adequate follow-up after an acute asthma episode, including review of medications, triggers and asthma action plan.
[√]
Managing acute asthma in children
If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.
[√]
Emergency management of acute asthma in a child is based on initial administration of salbutamol 4-6 puffs (< 6 years) or 8-12 puffs (≥6 years) via MDI.
I
Load the spacer with one puff at a time and give each puff separately.
III-1
If treatment with an oral corticosteroid (e.g. prednisolone 1 mg/kg up to 60 mg as a single daily dose) has been initiated for a moderate-to-severe acute episode, continue for up to 5 days.
Friday 30 January 2009
Thursday 29 January 2009
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