By John Rees
The hot version of this most sensible promoting ABC has been up-to-date to incorporate the hot British Thoracic Society instructions released in 2003 at the administration of bronchial asthma.
Concise and hugely illustrated, the e-book comprises chapters on leukotriene antagonists and lengthy performing beta agonists.
The major issues incorporated within the textual content hide the business enterprise of bronchial asthma care, analysis, administration of kids and toddler bronchial asthma.
An crucial textual content for GPs, scientific scholars, nurses and an individual facing the remedy of bronchial asthma in either adults and kids.
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Additional resources for ABC of Asthma
Great care should be taken in obtaining arterial blood because some asthmatic patients who have had bad experiences of arterial puncture may delay attendance at hospital because of the memories of pain. In patients with mild attacks a pulse oximeter should be used in the accident and emergency department. If saturation is Ն93% while the patient is breathing air and he or she does not have signs of severe asthma, then blood gas measurement can be omitted. In more severe cases oxygen saturation by pulse oximeter can be used to assess progress after the first arterial gas measurement, provided the initial carbon dioxide tension was not raised and there is no sign of appreciable deterioration.
If the initial response is adequate it may be possible to manage the patient at home if supervision is available. The primary treatment should then be followed up, usually by adequate bronchodilation and corticosteroids, and the response should be assessed by measurements of peak flow. The threshold for admission should be lowered if there has been a recent admission, previous severe attacks, poor patient perception of severity, or poor social support. Appropriate treatment should be started before transfer to hospital, with nebulised bronchodilators and oxygen continued during transfer Dangers of undertreatment Most deaths from asthma occur when the patient or doctor has failed to appreciate the severity of the attack.
There is little or no difference in the effectiveness of drugs that are nebulised or given intravenously in acute severe asthma, so nebulisation is generally preferable. It is helpful for general practitioners to have nebulisers available for acute asthmatic attacks. In acute asthma, ␤2 agonists are best given by nebulisers driven by oxygen as they may even worsen hypoxia slightly through an effect on the pulmonary vasculature. In general practice the use of oxygen as the driving gas is not usually practical.
ABC of Asthma by John Rees