c. Monitoring. During treatment for an acute asthma attack, monitor arterial
blood gases every 30 to 60 minutes.
d. Long-Term Therapy. Long-term therapy is an attempt to identify the cause
of asthma attacks and prevent those causes. Long-term therapy includes:
(1)
Discovering and avoiding, if possible, whatever causes the asthma
attack.
(2) Being desensitized against whatever is causing the asthma; for
example, desensitization against ragweed, other pollens, etc.
(3) Taking appropriate medication. (Tedral, Quibron, aminophylline, and
steroids are drugs that can be used to treat asthma).
e. Asthma in Children. The treatment for asthma in children requires providing
a pleasant and understanding home environment. Over-protection or parental
resentment must be avoided.
f. Acute Asthma Attack. An acute attack of asthma is treated as a respiratory
emergency. First, determine what medications the patient has taken within the last 12
hours.
(1)
Procedure for an adult patient is given below.
(a) Open the airway if it is not open.
(b) Give humidified oxygen or a nebulizer (a device for throwing a
spray). Use an intermittent positive pressure breathing (PPB) device if one is available.
Do not use the unmodified demand valve on the PPB device because the dry gases it
will send to the airway makes the mucus secretions worse.
(c) Establish an IV with a solution of five percent water with dextrose
(D5W) or D5/normal saline.
(d) Administer epinephrine 1:1000, 0.3 to 0.5 ml subcutaneously (adult
dose) if the patient has not taken large doses of inhalant bronchodilators. Repeat the
dose in thirty minutes, if necessary.
(e) Aminophylline may be given by adding 250 mg of the drug to a 250
ml bag of D5/W. This infusion can be attached to the IV in piggyback fashion.
(f) Bronchodilators such as epinephrine (Isoproterenol, Isuprel) or
Isoetharine (Bronkosol) may be administered by aerosol.
MD0568
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