(4) Ventilation (the cyclic process of breathing in and breathing out) is
progressively impaired.
(5)
Worsening of these conditions:
(a) Hypoxia--abnormal reduction of oxygen in the body tissues; also
called oxygen deficiency.
(b) Hypercarbia--abnormally high concentration of carbon dioxide in the
blood.
(c) Acidosis--increase in the hydrogen ion concentration in body fluids
accompanied by a lowering of the pH level.
(d) Dehydration--decrease in the amount of water in the body or body
tissues.
(6) As acidosis worsens, bronchoconstriction (narrowing of the interior
space of the bronchi) becomes severe. Dehydration causes the mucus plugs to
become thicker and more tenacious. This all causes a continuous cycle.
b. Treatment of Acute Asthma. An acute attach of asthma is treated as a
respiratory emergency. Treat as follows.
(1)
Give oxygen to treat the child's oxygen deficiency.
(2) Administer bronchodilator medication. The drug of choice is
epinephrine, 1:1000. A 0.01 ml/kg to 0.3 ml dose is the maximum dosage. The dosage
may be repeated once or twice every 20 minutes. An aerosolized bronchodilator
through a nebulizer may be used.
CAUTION:
DO NOT administer epinephrine after the patient has used an over-the-
counter (OTC) bronchodilator. Otherwise, the patient may experience
severe circulatory disease or cardiac arrhythmias.
(3)
Encourage fluids to treat dehydration and to loosen mucus secretions.
(4)
Administer bicarbonate to treat acidosis.
(5) Some children may require steroids for a period of time to reduce the
edema and congestion of the bronchial membranes.
MD0584
3-14
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