Acute Asthma Mx



Background

Consider the following for all patients with severe asthma

  1. Nasal prongs and highest tolerable O2flow. This can be given in addition to the 6 litres O2/min driving the nebuliser.
  2. IV fluids (2 l for average adult) on basis that the patient is dehydrated.
  3. IV magnesium 2g over 5 - 10 minutes has been shown to be useful [Cochrane]
  4. Start systemic steroids early [Cochrane]
  5. The use of intravenous beta 2 antagonists is controversial [Cochrane]

Management


Normal Peak Flow in Men

Height (top row = metres, 2nd row =inches)
1.55 1.6 1.65 1.7 1.75 1.8 1.85
Age 61 63 65 67 69 71 73
25 515 534 552 570 589 607 625
30 502 520 539 557 576 594 612
35 489 508 526 544 563 582 600
40 476 495 513 531 550 568 586
45 463 482 501 519 537 556 574
50 450 469 487 505 524 543 561
55 438 456 475 493 511 530 548
60 424 443 462 480 498 517 535

Normal Peak Flow in Women

Height (top = metres. Second row =inches)
1.45 1.5 1.55 1.6 1.65 1.7 1.75
Age 57 59 61 63 65 67 69
25 365 383 400 416 433 449 466
30 357 374 390 407 423 440 456
35 348 365 381 398 414 431 447
40 339 356 372 389 405 422 438
45 330 347 363 380 397 413 429
50 321 338 354 371 388 404 420
55 312 329 345 362 379 395 411
60 303 320 336 353 370 386 402


Content by Dr Íomhar O' Sullivan 23/04/2004. Reviewed by Dr ÍOS 20/07/2005, 30/04/2007. Last review Dr Kanti Dasari, Dr ÍOS 10/06/21.