BREATHE EASY BASICS
This pathophysiological feature causes airflow obstruction during an asthma exacerbation.
Bronchoconstriction
Contrary to popular belief, this vital sign often rises before hypoxia develops.
Respiratory Rate
This medication is considered first-line bronchodilator therapy in acute asthma.
Salbutamol
This common side effect of salbutamol may be mistaken for worsening patient anxiety.
Tremor
A patient presents with wheeze that is heard loudest over the neck rather than the chest. This alternative diagnosis should be considered.
Vocal cord dysfunction
This clinical sign is a more reliable indicator of severe asthma than the loudness of wheeze.
Increased work of breathing (accessory muscle use/retractions)
This is the single most concerning auscultatory finding in a patient with severe asthma.
Silent Chest
This anticholinergic is commonly added for moderate-to-severe exacerbations.
Ipratropium bromide
A patient presents with sudden-onset wheeze immediately after eating a meal containing nuts. What diagnoses must be considered before assuming this is an isolated asthma exacerbation?
Anaphylaxis.
An intubated asthma patient develops increasing peak airway pressures and hypotension. This ventilation complication is the most likely cause.
Dynamic hyperinflation (auto-PEEP)
This assessment finding is considered a marker of severe asthma and indicates significant airflow limitation.
An inability to speak in full sentences.
This change in mental status suggests impending respiratory failure.
Confusion, drowsiness, or reduced consciousness
Which class of medication treats the underlying airway inflammation rather than providing immediate bronchodilation.
Corticosteroids
This electrolyte abnormality should be monitored in patients receiving prolonged or frequent salbutamol therapy.
Hypokalaemia
A 24-year-old with severe asthma suddenly develops hypotension, distended neck veins, and worsening respiratory distress after intubation. This diagnosis must be considered immediately.
Tension pneumothorax.
This physical assessment finding suggests severe airflow obstruction and increased work of breathing in an asthma exacerbation.
Use of accessory muscles.
During treatment for a severe asthma exacerbation, a patient experiences sudden respiratory deterioration and unilateral reduced air entry. This complication should be suspected.
Pneumothorax
This IV medication may be considered in life-threatening asthma not responding to initial therapy.
Magnesium sulfate
A patient receiving continuous salbutamol develops tachycardia, tremor, and rising lactate levels. What complication should be suspected?
Salbutamol toxicity
Despite aggressive asthma treatment, a patient has persistent unilateral wheeze. This diagnosis should be investigated.
Inhaled foreign body.
This mechanism causes dynamic hyperinflation and increased work of breathing in severe asthma.
Air Trapping
A patient with severe asthma becomes increasingly agitated, then suddenly appears calm and less distressed despite minimal air entry. This change should raise concern for what?
Impending respiratory failure
This medication may be considered in refractory, near-fatal asthma because of its beta-agonist effects.
Adrenaline
This severe asthma complication can result from prolonged air trapping and may cause hypotension and cardiovascular compromise.
Dynamic hyperinflation (auto-PEEP)
A patient with severe asthma suddenly becomes difficult to ventilate, develops neck swelling, and crepitus is palpated over the chest wall. This diagnosis should be suspected.
Subcutaneous emphysema (or pneumomediastinum)