Page 222 - 2021 IDMT Digital
P. 222
Chapter 7
PULMONARY PROTOCOLS
ASTHMA, ACUTE
Introduction:
• $VWKPD LV D FRQGLWLRQ FKDUDFWHUL]HG E\ D UHYHUVLEOH REVWUXFWLRQ WR DLU IORZ FDXVHG E\
LQFUHDVHG UHVLVWDQFH LQ WKH PHGLXP VL]HG EURQFKL
• 7KH UHDFWLRQ LV D UHVSRQVH WR DQ H[WHUQDO WULJJHU RU VWLPXOL WKDW LQGXFHV EURQFKLDO VPRRWK
PXVFOH VSDVP PXFRVDO HGHPD KHDY\ VHFUHWLRQV DQG LQIODPPDWLRQ
• &RPPRQ WULJJHUV LQFOXGH FROG DLU H[HUFLVH VPRNH DOOHUJHQV RU UHVSLUDWRU\ WUDFW
LQIHFWLRQV
Subjective:
• 6LJQV DQG 6\PSWRPV
o '\VSQHD ZKHH]H FRXJK DQG FKHVW WLJKWQHVV
o 0D\ EH HSLVRGLF ZLWK DV\PSWRPDWLF SHULRGV
• )RFXVHG +LVWRU\
o 7LPLQJ WULJJHUV RWKHU 85, W\SH V\PSWRPV
o 8VH RI D UHVFXH LQKDOHU KRZ RIWHQ
o +LVWRU\ RI DOOHUJLHV RU UDVK
o 6PRNLQJ KLVWRU\ OLYLQJ VLWXDWLRQ
o 3HUVRQDO RU IDPLO\ KLVWRU\ RI DVWKPD
Objective:
• 3K\VLFDO ([DP
o $VVHVV YLWDO VLJQV HPSKDVLV RQ SXOVH R[LPHWU\
o 1DVDO PXFRVDO VZHOOLQJ VHFUHWLRQV DQG SRO\SV SRVVLEOH HF]HPD
o :KHH]LQJ RU SURORQJHG H[SLUDWRU\ SKDVH
'XULQJ D VHYHUH H[DFHUEDWLRQ WKH DLUIORZ PD\ EH WRR OLPLWHG WR SURGXFH
ZKHH]H
o $FFHVVRU\ PXVFOHV RI UHVSLUDWLRQ
• 7RROV
o 6SLURPHWU\ DQG RU SHDN IORZ WR DVVHVV VHYHULW\
o ; UD\ XVXDOO\ QRUPDO EXW PD\ VKRZ K\SHULQIODWLRQ
Assessment:
• 'LIIHUHQWLDO
o 9RFDO FRUG dysfunction flattened inspiratory loop on VSLURPHWU\
o )RUHLJQ ERG\ DVSLUDWLRQ KLVWRU\
o $QJLRHGHPD VZHOOLQJ DQG DOOHUJLF UHDFWLRQ HYLGHQW
o 9LUDO LQIHFWLRQ 85, VLJQV DQG V\PSWRPV
o Pulmonary embolus FKHVW SDLQ ZLWK KLVWRU\ RI XQLODWHUDO ORZHU H[WUHPLW\ SDLQ
DQG VZHOOLQJ
[ 221 ]
