Page 92 - PJ MED OPS Handbook 8th Ed

Asthma (Reactive Airway Disease)

SPECIAL CONSIDERATIONS:
Other disorders to consider: anaphylactic reaction, spontaneous pneumothorax, HAPE, and
pulmonary edema.

Signs and Symptoms:
1. Wheezing bilaterally. Unilateral wheezing could be foreign body, tumor, or other obstruction.
2. Dyspnea
3. Difficulty with speaking in full sentences

Management:
1. Albuterol (Ventolin) (metered dose inhaler – works best when used with spacer), 2–3 puffs
q5min, repeat up to 3 times
2. IF THERE IS NO RESPONSE TO ALBUTEROL (Ventolin)
Epinephrine 0.5mg (0.5mL of 1:1000 solution) IM. DO NOT USE INTRAVENOUSLY. May re-
peat one epinephrine dose in 5–10 minutes
3. Oxygen with pulse oximetry monitoring
4. IV access with saline lock
5. Dexamethasone (Decadron) 10mg IV/IM/PO
6. If there is fever, pleuritic chest pain and productive cough, treat per Bronchitis/Pneumonia
Protocol

DISPOSITION:
1. Urgent evacuation if no response to treatment.
2. If the patient responds to management, observe for 4 hours.
a. Return to Duty if there is no wheezing or dyspnea and normal oxygen saturation. Con-
tinue albuterol (Ventolin) (2 puffs q6hr) and re-evaluate in 24 hours. Continue decad-
ron 10mg IM daily for 4 days.
b. Urgent evacuation if symptoms persist.

90 n Pararescue Medical Operations Handbook / 8th Edition