Status asthmaticus is a severe, prolonged asthma attack that does not respond\u00a0to conventional methods of treatment.<\/p>\n
This condition is considered a medical\u00a0emergency.<\/p>\n
Proceed in the following manner with patients having this type of asthma\u00a0attack:<\/p>\n
a. History<\/strong>. It is important to know the patient’s recent medical history. Ask the\u00a0questions listed below of or about the patient. Then, record that information.<\/p>\n (1) How long has the child been wheezing?<\/p>\n (2) How much fluid has the child taken?<\/p>\n (3) Has the child had a recent infection?<\/p>\n (4) What medications has the child been given? When were the\u00a0medications given, and what was the amount of each medication?<\/p>\n (5) Is the child allergic to anything? If so, what?<\/p>\n (6) Has the child been hospitalized recently?<\/p>\n b. Physical Examination<\/strong>. Give the child a physical examination, paying\u00a0particular attention to the following:<\/p>\n (1) General appearance. Is the child sitting or lying down? In how much\u00a0distress is the child? A child having a mild asthmatic attack will lie down but prefers to\u00a0sit. A child having a severe asthmatic attack appears exhausted and may be unable to\u00a0move from the position he is in.<\/p>\n (2) State of consciousness. Very serious signs include sleepiness, stupor,\u00a0and coma. These signs indicate the patient is experiencing severe degrees of\u00a0hypercarbia, hypoxemia, and acidosis.<\/p>\n WARNING: \u00a0A patient having an asthma attack and being very\u00a0sleepy at the same time is seriously ill.<\/strong><\/em><\/p>\n (3) Vital signs. As the asthma attack becomes more severe, the patient’s\u00a0pulse becomes weaker and faster, and his blood pressure falls.<\/p>\n (4) Skin and mucous membranes. Check the child’s skin for signs of\u00a0dehydration. Check his lips and nailbeds for evidence of cyanosis.<\/p>\n (5) Chest sounds.<\/p>\n (a) Listen to the child’s respiratory sounds. You are checking for rales\u00a0(abnormal respiratory sounds, sounding high-pitched or like rubbing hair together near\u00a0your ear), and wheezes (high- pitched, whistling sounds). The patient’s chest sounds\u00a0are noisy in a mild or moderate asthma attack. As the asthma attack progresses, there\u00a0are increased breath sounds with loud, expiratory wheezes and sometimes rales. As\u00a0the asthma attack becomes even more severe, the patient’s breath sounds are harder\u00a0and harder to hear.<\/p>\n (b) Be sure to listen to the child’s entire chest. A child with localized\u00a0wheezing may have a foreign body obstructing his airway. A child with asthma,\u00a0however, will have wheezing which can be heard all over his chest.<\/p>\n CAUTION: A silent chest means danger!<\/strong><\/em><\/p>\n c. Treatment<\/strong>. Treatment is similar to that for acute asthma and includes the\u00a0following:<\/p>\n (1) Administer humidified oxygen by mask.<\/p>\n (2) Begin an IV lifeline with D5\/W or D5\/.25 normal saline.<\/p>\n (3) Give epinephrine 1:1000 SQ in the dose of 0.01 mg per kilogram.\u00a0Repeat in 20 to 30 minutes.<\/p>\n CAUTION: Remember, the use of epinephrine may be hazardous to the child if he\u00a0has already taken high doses of bronchodilator medication by inhalation!\u00a0To avoid such a medication mistake, be sure you have taken a good\u00a0history of the child.<\/strong><\/em><\/p>\n (4) You may administer aerosolized bronchodilator through the nebulizer.\u00a0Epinephrine or bronchosol may be given. Monitor the child’s heart rate and discontinue\u00a0the nebulizer if his heart rate exceeds 160 beats per minute or if dysrhythmias develop.<\/p>\n (5) Encourage the child to cough up any secretions as he takes the\u00a0bronchodilator treatment.<\/p>\n (6) Be prepared to administer these medications:<\/p>\n (a) Aminophylline, in the dosage 2 to 4 mg per kilogram diluted in at\u00a0least 10 ml of D5\/W, to be given IV over no less than 15 minutes.<\/p>\n (b) Hydrocortisone in the dosage 5 mg per kilogram drawn up in a\u00a0syringe to be added to the IV bag.<\/p>\n (7) Monitor the child’s cardiac rhythm.<\/p>\n","protected":false},"excerpt":{"rendered":" Status asthmaticus is a severe, prolonged asthma attack that does not respond\u00a0to conventional methods of treatment. This condition is considered a medical\u00a0emergency. Proceed in the following manner with patients having this type of asthma\u00a0attack: a. History. It is important to know the patient’s recent medical history. Ask the\u00a0questions listed below of or about the patient. … Continue reading 3-13. STATUS ASTHMATICUS<\/span>