You are working as part of a double Tech crew on an Ambulance when you are called to a red call of agonal/ineffective breathing. The address is 10 minutes away. As you are travelling to the scene, more information is provided, it is a 26-year-old female suffering from an asthma attack. A Paramedic on an RRV is 15 minutes away. You arrive on scene and are led into the property by the patients’ mum. The scene is safe.
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In the living room you find the patient in a tired state on the sofa. Just looking at her, her resps are elevated but with little movement, she is pale and clammy with a blue tinge around her mouth and fingers, and she looks very weak and tired. Mum explains that the patient has been to hospital before because of her asthma and has been to ITU. Looking at the initial range of information, what class of asthma would you give this
You realise the severity of the patient and start treatment to the obvious Airway and Breathing problems. Your colleague starts setting up a nebuliser. What initial drug would you consider nebulising
While your colleague sets up the nebuliser, you quickly auscultate the chest. You hear no noise on inspiration and expiration. What is this commonly called in relation to asthma
Given the severity of this patients’ condition, what further drug could you escalate to give in order to treat the patient
As there are no contra-indications in this case, your colleague has administered the nebuliser with Salbutamol while you draw up the Adrenaline. What initial dose of Adrenaline 1:1000 IM will you give
Your colleague has come back with some observations, O2 sats of 91% with nebuliser, resps of 30, HR of 140, BP 102/69. Given the scenario and circumstances, are there any contra-indications to giving the Adrenaline 1:1000 IM
You administer the Adrenaline 1:1000 IM. The initial Salbutamol is starting to run out. What second drug could you nebulise
While your colleague sets up the second nebuliser, what further drugs could you consider
You draw up the Hydrocortisone, what is the dosage for IM administration in Life-threatening Asthma
You clear the contra-indications and administer the Hydrocortisone IM. You note the patients’ condition has slightly improved with resps easing slightly and sats coming up to 94%. You grab the carry chair and get the patient quickly into the back of the vehicle. As you’re on board, the RRV turns up and you quickly hand over the Paramedic the situation and treatment so far. You start your way to the nearest A+E with a pre-alert put in. The Paramedic is on the back with you while your colleague drives. The patients’ condition on route begins to deteriorate again. Can you give a repeat dose of Adrenaline IM 1:1000