![]() ![]() Note that pulse oximetry lag, and the physiological reserve of many patients means that a falling pO2 on pulse oximetry is a late finding, indicating a severely unwell or peri-arrest patient. Pulse oximetry can be useful in assessing the severity of an asthma attack or monitoring for deterioration. It has the following characteristic findings on examination It is necessary to identify it early as it may lead to high mortality. Life-threatening asthma is a type of asthma that does not respond to systemic steroids and beta 2 agonist nebulization. Wheezing may be absent, and bradycardia may occur, indicating severe respiratory muscle fatigue. In life-threatening asthma, the chest may be silent, as air cannot enter or leave the lungs, and there may be signs of systemic hypoxia.Ĭhildren with imminent arrest may appear drowsy, unresponsive, cyanotic, and confused. On auscultation, a bilateral, expiratory wheeze will be heard. Patients will show some respiratory distress, often sitting forward to splint open their airways. Physical exam findings will depend on whether the patient is currently experiencing an acute exacerbation.ĭuring an acute exacerbation, there may be a fine tremor in the hands due to salbutamol use, and mild tachycardia. Many asthmatics have nocturnal coughing spells but appear normal in the day time There may be some mild chest pain associated with acute exacerbations. Patients may give a history of other forms of atopy, such as eczema and hay fever. There is often diurnal variation, with symptoms being worse at night. Patients will usually give a history of a wheeze or a cough, exacerbated by allergies, exercise, and cold. almost 50% of children with asthma have a decrease in severity or disappearance of symptoms during early adulthood. Of all the asthma cases, about 66% are diagnosed before the age of 18 years. Asthma prevalence is greater in extreme of ages due to airway responsiveness and lower levels of lung function. After puberty, the prevalence of asthma is greater in females, and adult-onset cases after the age of 40 years are mostly females. In childhood, asthma is more common in boys with a male to female ratio of 2:1 until puberty when the ratio becomes 1:1. Asthma is associated with exposure to tobacco smoke and inhaled particulates and is thus more common in groups with these environmental exposures. Up to 40% of children will have a wheeze at some point, which, if reversible by beta-2 agonists, is termed asthma, regardless of lung function tests. It is significantly more common in children. Asthma is a common pathology, affecting around 15% to 20% of people in developed countries and around 2% to 4% in less developed countries. ![]()
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