200 – I know what it is, but what do I do?

You’ve had your morning caffeine and immediately pick up that the patient’s respiratory rate is high enough to meet the criteria for acute severe asthma:

  • PEF 33-50% best or predicted
  • Respiratory rate ≥25/min
  • Heart rate ≥110/min
  • Inability to complete sentences in one breath

 

You recognise that her speech being limited by breathlessness is also a concern however you know that she is alert, not cyanosed and there are no signs of fatigue. Therefore you correctly conclude that there is no evidence currently to think her asthma attack is life threatening.

 

After correctly identifying this patient as having severe acute asthma, you quickly ask the nurse to pop her on some oxygen and get more information with:

Routine bloods, ABG, CXR

ABG, peak flow

Full clinical examination, routine bloods, CXR