Status Asthmatic Us

Status asthmaticus • Emergency and life threatening • Result in respiratory failure with hypoxia, hypercarbia, and respiratory/metabolic acidosis • Management: o ABC, 100% O2 o Intubate deep/ also may consider BiPAP o Ventoline, ipratrupium bromide, steroids, thiophylline, leukotrine inhibitor, ABx if suspect infection o Other consider Ventoline IV, Isoprel/pei gtt, Ketamine, BNZ o Last→ volatile agent, and paralyze o Ventilation: volume control Vt 6-10ml/kg, PEEP 5-10, target→ normal PO2, pH, and PCO2, keep the platue pressure < 30cmH2O o If need switch to pressure control o Also may consider Heliox o Be aware of AutoPEEP→ disconnect the bag, if on vent → reverse ratio ventilation