Learning Center Articles

Interprofessional care : Asthma

Interprofessional care

  • The current guidelines focus on
    • Assessing the severity of the disease at diagnosis and initial treatment and then
    • Monitoring periodically to control the disease
  • Intermittent and persistent asthma
    • Avoid triggers of acute attacks
    • Pre-medicate before exercising
    • Short-term (rescue or reliever) medication
    • Long-term or controller medication
  • Acute asthma exacerbations
    • Respiratory distress
    • Treatment depends upon severity and response to therapy
      • Classified as mild, moderate, severe, or life-threatening
      • Management focuses on correcting hypoxemia and improving ventilation
    • O2 given via nasal cannula or mask to achieve a PaO2 of at least 60 mm Hg or O2 saturation greater than 90%
      • Continuous oxygen monitoring with pulse oximetry
    • Bronchodilator treatment
      • Short-acting β2-adrenergic agonists (SABAs)
  • Assessment during acute exacerbation
    • Respiratory and heart rate
    • Use of accessory muscles
    • Percussion and auscultation of lungs
    • PEFR to monitor airflow obstruction
    • ABGs
    • Pulse oximetry
  • Severe and life-threatening exacerbations
    • “Silent chest”
      • Severely diminished breath sounds
      • Absence of wheeze after patient has been wheezing
      • Patient is obviously struggling
      • Life-threatening situation
      • Requires ED and possible ICU
      • IV magnesium sulfate
      • 100% oxygen
      • Hourly or continuous nebulized SABA
      • IV corticosteroids
  • Bronchial thermoplasty
    • Catheter applies heat to reduce muscle mass in the bronchial wall
    • Reverses accumulation of excessive tissue that causes narrowing of airway