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Resuscitation techniques in asthma

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Information about Resuscitation techniques in asthma
Health & Medicine

Published on October 13, 2014

Author: mex1877

Source: slideshare.net

Description

Second series for Resuscitation in difficult situations.
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1. RESUSCITATION TECHNIQUES IN ASTHMA B Y A N U G O M E M E K A M B B C H , M P H , M S C O C C M E D , I G C N E B O S H

2. WELCOME & INTRODUCTIONS  Logistics  Emergency exits  Restrooms 2

3. AGENDA  Introduction  Epidemiology  Complications of Asthma  Management of Cardiac arrest in Asthma  Definitive Treatment for Asthma  Conclusion  References  Q&A 3

4. INTRODUCTION  Various difficult situations may arise that lead to cardiac arrest.  The skill of bystanders is paramount for outcome of survival.[1]  Resuscitation will need to be modified in these situations depending on their peculiarities and reversible causes.  Early recognition and proper management of Airway Breathing Circulation Disability and Exposure (ABCDE) is very important for survival.[2]  Image: ht tp: / / totalassist .co.uk/can-a-cold-cause-a-deadly-asthma-at tack/ 4

5. INTRODUCTION  This presentation is a review based on 2010 Guidelines by American Heart Association and European Resuscitation Council.  Prior Knowledge of current BLS/ACLS guidelines or resuscitation is assumed. 5  Image: ht tp: / / tebesi te.com/2014/08/get t ing-more-of-your -asthma-medicat ion.html /_65110578_c0020837-_asthma_t reatment_adolescent_-spl

6. EPIDEMIOLOGY  Globally over 300million people have asthma[3,4]  .  Asthma accounts for 1% of morbidity burden worldwide. [3,4]  There is an annual mortality rate of 250,000, with a prevalence of 1-18% in Europe. [3,4]  It is responsible for 2million Emergency room visits in the United states annually.[3,4] 6  Image 1: ht tp: / /papaheal th.com/ is -asthma-heredi tary/  Image 2: ht tp: / /en.wikipedia.org/wiki /Bronchoconst r ict ion#mediaviewer /Fi le:Blausen_0620_ Lungs_NormalvsInf lamedAi rway.png

7. COMPLICATIONS OF ASTHMA  ASPHYXIA  This is the leading cause of death here and may arise from the following[3,4]:  - severe bronchoconstriction  - mucus plugging.  The absence of wheeze may imply severe airway obstruction.[3,4] 7  Image 1: http://www.bbc.co.uk/news/heal th -20931946  Image 2: ht tp: / /www.ucdmc.ucdavis.edu/cppn/classes/mechanical_vent i lat ion.html

8. COMPLICATIONS OF ASTHMA  CARDIAC ARREST  This is rare and may arise after the following.[3,4]  - prolonged hypoxaemia,  - electrolyte imbalance  - drug side effects[3,4] 8  Image 1: ht tp: / /deposi tphotos.com/5730474/stock - i l lust rat ion-asthma-man.html  Image 2: ht tp: / /en.wikipedia.org/wiki /Mechanical_vent i lat ion

9. COMPLICATIONS OF ASTHMA  Other complications are:  BILATERAL TENSION PNEUMOTHORAX [3,4]  PNEUMONIA [3,4]  ATELECTASIS [3,4]  PULMONARY EDEMA [3,4]  These can lead to death in this condition.[3,4] 9  Image 1: ht tp: / /www.nlm.nih.gov/medl ineplus/magazine/ issues/ fal l11/ar t icles/ fal l11pg4.html  Image 2: ht tp: / / in. reuters.com/ar t icle/2014/07/16/heal th -asthma-drug-idINKBN0FL2WN20140716

10. MANAGEMENT OF CARDIAC ARREST IN ASTHMA  In the event of a cardiac arrest arising from asthma, normal BLS and ACLS guidelines are to be followed.[2,3,4]  There is need however for  - Early endotracheal intubation  - Mechanical ventilation, with waveform capnography to ensure and monitor proper tube insertion 10  Image 1: ht tp: / /en.wikipedia.org/wiki /Tracheal_intubat ion  Image 2: http: / /www.carefusion.com/medical - products/ respi ratory/vent i lat ion/carefusion -vent i lat ion-system.aspx

11. MANAGEMENT OF CARDIAC ARREST IN ASTHMA  -Oxygen should be given at :  - A high flow rate  - But at reduced respiratory rate with shorter inspiration and longer expiration delivery rate of 1:4 or 1:5 unlike in non-asthmatics.[ 2,3,4]  Pleural ultrasound scan(preferable) or  Chest X-ray can be used to rule out tension pneumothorax.[3,4] 11  Image 1: ht tp: / /www.bbc.co.uk/news/heal th -11392899  Image 2: ht tp: / /nursing.nmmu.ac.za/Shor t -Courses/Mechanical -Vent i lat ion

12. DEFINITIVE TREATMENT FOR ASTHMA  The definitive treatments of value to the patient care consists of the following:  Bronchodilators (β2 Agonists short acting) inhaled or IV[3,4]  IV Corticosteroids[3,4]  Anticholinergics (Ipratropium bromide) inhaled or IV[3,4]  Epinephrine Subcut or IM [3,4]  Leukotriene receptor Antagonists[3,4]  Magnesium sulfate inhaled or IV [3,4] 12  Image 1: ht tp: / /www.doctorwel lgood.com/cl inic -a-z/asthma.html  Image 2: ht tp: / /heal thmaven.blogspot .com/2012/02/asthma -drugs-ki l l -more- than-asthma- fda.html

13. DEFINITIVE TREATMENT FOR ASTHMA  However use of Methylxanthines: e.g. Aminophylline are NO longer recommended in the management, due to their side effects and a lack of strong evidence of its benefits.[3,4] 13  Image 1: ht tp: / /www.bbc.co.uk/science/0/21857582  Image 2: ht tp: / /www.sciencephoto.com/media/250494/view

14. CONCLUSION  Difficult situations may arise or lead to need for resuscitation.  Modifications and consideration of reversible factors, including importance of making early decisions to - initiate resuscitation - invite expert and - manage the patient accordingly is paramount to survival in these situations. 14  Image: ht tp: / /www. tacomacc.edu/areasofstudy/career t raining/ respi ratorytherapy/

15. CONCLUSION  Mastery and awareness of the basic techniques and guidelines for BLS/ACLS by everyone is crucial to success in resuscitation in theses situations.  Get Trained to save lives. 15  Image: ht tp: / /en.wikipedia.org/wiki /Cardiopulmonary_resusci tat ion

16. REFERENCES  1. J.R Casal Codesido, y M.J. Vazquez Lima, 2007; Out-of Hospital Cardiopulmonary Resuscitation: Where are We now? Emergencias 2007;19:295-297.  2. Australian Resuscitation Council; New Zealand Resuscitation Council, 2011; Guideline 11.10 Resuscitation in Special Circumstances: 1-14  3. Jasmeet Soar et al,2010, European Resuscitation Council Guidelines for 2010 Section 8. Cardiac arrest in special circumstances: Electrolyte abnormalities, poisoning, drowning, accidental hypothermia, hyperthermia, asthma,anaphylaxis, cardiac surgery, trauma, pregnancy, electrocution; Elsevier Ireland Ltd, Resuscitation 81(2010)1400-1433, doi:10.1016/j.resuscitation.2010.08.015  4. Terry L. Vanden Hoek et al, 2010, Cardiac Arrest in Special Situations: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care; Circulation.2010:122:S829-S861; doi:10.1161/CIRCULATIONAHA.110.971069; Online ISSN:1524-4539 16

17. . 17  Image:http: / /handsonblog.org/2011/01/26/eight - t ips-for-wr i t ing- the-per fect - thank-you- note/

18. QUESTIONS 18  Image: ht tp: / /www.openbkautoloans.com/wp -content /uploads/2012/04/quest ion - and-answers-bad-credi t -car- f inancing. jpg

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