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