Asthma: Unconscous (Adult) |
| Status |
| Unconscious / Becomes Unconscious - with poor or no ventilation but still with cardiac output |
| Pt requires immediate assisted ventilation | |
| Ventilate to 5-8 ventilations/minute, Tidal Volume = 10ml/kg | |
| Moderately high respiratory pressures | |
| Allow for prolonged expiratory phase | |
| Gentle lateral chest pressure during expiration if required | |
| Adequate response | Inadequate response | |||
| Mx as per Asthma - Severe Respiratory Distress | Salbutamol IV, 250mcg - Repeat Salbutamol IV, 125mcg, 5 minutely if required (max. 500mcg) |
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| Dexamethasone IV 8mg | ||||
| If unable to gain IV or unaccredited in IV Salbutamol - Adrenaline IM 300mcg (1:1,000) - Repeat Adrenaline IM 300mcg, 20 minutely as required (max. 900mcg IM) |
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| Mx as per Asthma - Severe Respiratory Distress | ||||
| Consider Intubation | ||||
| If Pt loses output at any stage, see Asthma: No Output | ||||
| Special Notes |
| High EtCO2 levels should be anticipated in the intubated asthmatic Pt. - EtCO2 levels of 120mmHg in this setting are considered safe, and when managing ventilations, be conscious of the effect of gas trapping when attempting to reduce EtCO2. |
Extreme care must be taken with assisted ventilation as gas trapping and barotrauma occurs easily in asthmatic Pts with already high airway pressures. |