Pre class

🌬 Severe Acute Asthma – Nursing Notes

🚨 Signs of Severe Life-Threatening Asthma

• Unable to speak full sentences

• Accessory muscle use

• Silent chest (no air entry = emergency)

• Cyanosis (blue lips)

• Tachycardia (HR > 120 bpm adults, > 130 bpm kids)

• Hypoxia (SpO₂ < 92%)

• Confusion, exhaustion → impending respiratory arrest!

🫧 Oxygen Therapy for Acute Asthma

• Aim: Keep SpO₂ > 94–98% in adults and children

• Delivery:

  • Start high-flow O₂: 10–15L/min via non-rebreather mask.

  • Then titrate down based on SpO₂ and clinical response.

🛑 Initial Management – "OSCAR" Mnemonic

(Oxygen, Salbutamol, Corticosteroids, Anticholinergic, Reassess)

🫁 Emergency Asthma Management Mnemonic — ASTHMA

A – Albuterol (Salbutamol) continuous nebs
S – Steroids (IV hydrocortisone or oral prednisolone)
T – Theophylline (rare, ICU setting)
H – Help (escalate early – ICU, MET call)
M – Magnesium sulfate IV if not responding
A – Airways (intubation if arrest or failure!)

👶 Pediatric Acute Asthma

• Very similar steps but adjust medication doses to weight (mg/kg).

• Use spacer and mask for kids under 6 years.

• Oxygen target also > 94%.

• Add Magnesium sulfate IV early if severe.

🔥 Red Flags for Life-Threatening Asthma

• Silent chest

• Low SpO₂ despite oxygen

• Bradycardia

• Fatigue/confusion

• Poor PEFR (<33% predicted)

👉 Call for MET/Code Blue early if ANY of these signs appear!

🧠 Nursing Responsibilities (Mnemonic: AIR CARE)

A – Assess ABCs (airway, breathing, circulation)
I – Initiate oxygen therapy immediately
R – Rapidly administer bronchodilators
C – Check vitals frequently (SpO₂, HR, RR, BP)
A – Administer steroids & nebulised meds
R – Reassure patient (calm environment)
E – Escalate care early if not improving

Summary Poster Line

✅ Recognize early
✅ Oxygen high-flow
✅ Rapid bronchodilator + steroids
✅ Reassess + escalate
✅ Support breathing (intubate if needed)