Auscultate lung sounds Take VS Monitor ABG Pulse oximetry PEFR
Identify & avoid personal triggers Avoid exposure to cold air Avoid NSAIDs, aspirin, nonselective B blockers
Desensitization
Prompt diagnosis & treatment of URTI & sinusitis Maintain OFI 2-3L/day Good nutrition, adequate rest
Infection Genetics Allergens Exercise Irritants
Immune activation
Activates B cells
Secretes Immune Corticosteroids (1st line therapy) Binds to mast Monoclonal antibody cells in the bronchi Immunoglobulin
Mast cell stabilizers
Mast cell degranulation
Leukotriene modifiers
Release of inflammatory mediators
Vasodilation Increase vascular permeability
Bronchoconstrictio n (smooth muscle contraction)
Increase mucus productionImpair ed ciliary function
Vascular congestion Edema
Bronchodilators : B2 Adrenergic agonist
Thickened airway walls
Mucosal wall swelling
Narrowed airways
Cough
Unrelieved/untrea ted
Air flow limitation
Thick, stringy mucus
Exhaustion
Wheezing Hyperresonan ce
Dyspnea: Inc RR; use of accessory muscles
Decrease oxygentation
Lack of muscle force
Hypoxemia
Significant decrease in air movement
Inability to complete sentence
Restlessness Increased anxiety Inappropriate behavior Inc PR and BP
Diminished/absent breath sounds
Positioning Talking down & abdominal breathing Pursed lip breathing WOF HR>120 bpm Pulsus paradoxus RR >30 rpm Wheezessilent Patient speaks in words O2 sat <90; paO2 <60 mmHg PaCO2>45 mmHg; PEFR<100L/min
Respiratory failure
2-4 puffs short-acting B adrenergic agonist every 20 minutes 3x or 1 nebulized treatment