Ahmad, a 36-year-old, is brought to your room by his wife Ibtesam.

He is very breathless and is only able to speak in single words.

Ibtesam tells you he has had asthma for years but she has noticed he has been taking his blue puffer more frequently lately, and for the last few hours he has been using it about every 15-20 minutes.

Question 1

What is your management? The following list of management options are all OK.
Select your preferred first choice then click Next >> to view the author's answer.

a. Take a history.

b. Perform a rapid assessment.

c. Examine the respiratory system.

d. Administer O2 (8 litres/min) and inhaled bronchodilator e.g. salbutamol.

e. Commence steroids (e.g. oral prednisolone 50-100mg start or intravenous (IV) hydrocortisone 250 mg).

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Answer 1

b. Perform a rapid assessment - This is the author's 1st choice.

The first step is to make a rapid assessment, and this is done by observing use of accessory muscles, presence of cyanosis, inability to answer questions, audible wheezing etc. This is done in a matter of seconds. Taking further history and examining the respiratory system can wait until Ahmad is more comfortable.

 

When completed, click MORE for further information.