Medspresso #Episode 51: Asthma

Dr Swapnil Pawar June 21, 2022 88

share close
  • cover play_arrow

    Medspresso #Episode 51: Asthma
    Dr Swapnil Pawar


Written by Dr Andrew Lam


Classification of Asthma Severity

Mild/Moderate Severe Life Threatening
O2 Saturations >94% 90-94% <90%
Auscultation Wheeze May be similar to mild/moderate Silent chest
Speech Can finish a sentence Phrases Single words
Respiratory Distress Minimal Some use of accessory muscles Severe respiratory effort
Level of Consciousness Alert May be similar to mild/moderate Drowsy


Acute Management of Asthma 


PRN Salbutamol (4-12 puffs) as required


Severe/Life Threatening

  • Salbutamol 5mg Nebulised (or 12 puffs) q20mins


  • Ipratroprium 500mcg Nebulised (or 8 puffs) q20 mins

Continue this for the first hour. If therapy ineffective:

  • 10 mmol MgSO4 infused over 20 minutes


And consider further salvage therapy:

  • IV Adrenaline infusion
  • IV Ketamine infusion
  • IV Aminophylline


Also give Hydrocortisone 100mg QID IV for prevention of secondary reaction and bronchospasm

Prevention of Asthma

Prevention of asthma flares occurs in a step-wise approach:


Step 1 – PRN SABA

Step 2 – Low dose ICS + PRN SABA

Step 3 – Low dose ICS + LABA + PRN SABA

Step 4 – Medium dose ICS + LABA + PRN SABA. Alternatively low dose ICS + LABA + LAMA


Past this, referral to a respiratory physician is often warranted.

SABA – short acting beta agonist, ICS – inhaled corticosteroid, LABA – Long acting beta agonist, LAMA – Long acting muscarinic antagonist






Rate it
Previous episode
Management of Transient Ischaemic Attack
Medspresso Podcast
share playlist_add
  • 400


Status Epilepticus

Dr Swapnil Pawar June 6, 2022

play_arrow Status Epilepticus Dr Swapnil Pawar Status Epilepticus Blog written by Dr Ashly Liu Definition A seizure that lasts longer than 5 minutes, or having more than 1 seizure within […]

Read more trending_flat