Interventions
"This noninvasive respiratory therapy is heavily prioritized in acute COPD exacerbations to avoid the barotrauma, infections, and weaning difficulties associated with mechanical ventilation."
What is BiPAP?
"The use of these specific structures during inspiration on physical examination indicates diaphragmatic fatigue."
What are accessory muscles?
"This pharmacological class of agents (topically often used for glaucoma) are notorious for potentially triggering severe bronchospasm in susceptible asthmatic patients."
What are beta blockers?
"This anticholinergic agent targets larger, central airways to block vagal-mediated bronchoconstriction, and is routinely added to short-acting beta-agonists (albuterol) in the ED to reduce hospitalization rates in severe attacks."
What is ipratropium bromide?
"This gender demographic now accounts for greater than 50% of all COPD-related deaths, representing a doubling of prevalence over the last few decades."
When treating severe asthma exacerbations refractory to initial therapy, Tintinalli's notes that this dose (in grams) of intravenous Magnesium Sulfate should be administered slowly over 20 to 30 minutes."
What is 2 grams?
(will accept answer of 1-2 g)
"During an acute asthma attack, finding this specific, non-acidotic value on an arterial blood gas (ABG) is a major red flag indicating that the patient is fatiguing and impending respiratory failure is near."
What is a normal (or elevated) PaCO2 (partial pressure of carbon dioxide)?
Early in asthma exacerbations, hyperventilation typically causes hypocapnia; a normal or high PCO2 indicates the patient can no longer keep up with the work of breathing.
"In acute asthma management, the most heavily weighted risk factor for asthma-related death during a historical intake is having this in the patient's medical history."
What is a past history of severe exacerbation (or prior intubation/ICU admission for asthma)?
"This therapeutic gas mixture, consisting of an 80% and 20% mixture, is used to lower airway resistance in severe asthma, though it does not reliably change tracheal intubation or mortality rates."
What is heliox?
"When setting up initial mechanical ventilation for an intubated patient with acute asthma, you must avoid a high respiratory rate to prevent this life-threatening dynamic condition."
What is auto-PEEP (or severe gas trapping/air trapping)?
"This ominous clinical physical exam finding indicates the level of airflow obstruction where air movement is insufficient to promote an audible wheeze, reflecting extremely severe airflow obstruction."
What is a "silent chest"?
This anesthetic induction agent is favored during the intubation of severe asthmatics due to its intrinsic bronchodilatory properties.
What is Ketamine