MedBugs: SAQ #161

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Case: Severe asthma and NIV

A 28-year-old man is brought in by ambulance with acute respiratory distress. History of poorly controlled asthma with repeated ICU admissions. Vitals: HR 125 BP 100/60 RR 40 SpO2 94% on 15 L/min NRB.

1. What examination findings would you seek to assess severe vs life threatening asthma? 4 marks

The patient has features of severe asthma. You commence nebulised and IV bronchodilators, IV steroids and a MgSO4 infusion.

2. List four advantages and four disadvantages of non-invasive ventilation in management of acute severe asthma. 8 marks

Despite optimal medical management, the patient continues to deteriorate

3. List four indications for intubation. 4 marks

You successfully intubate the patient but shortly atierwards they arrest

4. What are four potentially reversible causes of arrest post-intubation in severe asthma and how would you address each? 4 marks

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Case: Severe asthma and NIV

1. What examination findings would you seek to assess severe vs life threatening asthma? 4 marks

2. List four advantages and four disadvantages of non-invasive ventilation in management of acute severe asthma. 8 marks

3. List four indications for intubation. 4 marks

4. What are four potentially reversible causes of arrest post-intubation in severe asthma and how would you address each? 4 marks

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