Asthma is characterised by hyper-reactive airways and inflammation leading to episodic, reversible bronchoconstriction in response to a variety of stimuli.
Pallor, cyanosis and exhaustion (late and preterminal signs)
Exclusion Criteria
Exclusion Criteria
Risk Assessment
Clinical Severity:
Mild / Moderate
Can walk, speak whole sentences in one breath
Oxygen saturation >94%
Wheeze might be evident
Severe
Use of accessory muscles of neck, intercostal muscles, or presence of 'tracheal tug' during inspiration or subcostal recession (i.e., abdominal breathing)
Unable to complete sentences in one breath due to dyspnoea
SpO2 is not a reliable isolated indicator of severity; a patient with a normal SpO2 reading can still be regarded as time critical due to carbon dioxide (CO2) retention.
Asthma is less likely to be the cause of wheezing in infants less than 12 months old.
If symptoms do not respond to treatment, reconsider the diagnosis.
Extreme care should be taken when ventilating an asthmatic patient; gently and at a rate of no more than 4-6 breaths per minute. This allows for adequate exhalation and avoids air trapping which may otherwise lead to reduced blood pressure and cardiac arrest
Officers may assist the patient in the administration of their own medication where clinically indicated
Be alert for rapid deterioration
Intermediate Care (EMT / Level 2)
If wheeze present, administer Salbutamol as per CPG