1. Resuscitation in special circumstances workshop Asthma
Version: Jun 2016

2. Learning outcomes At the end of this workshop you should be able to:
understand how to assess and treat the patient with asthma
recognise the signs and symptoms of acute, severe life-threatening, and near-fatal asthma
understand the potential complications following tracheal intubation and ventilation

3. What action will you take?
Case study
Clinical setting and history
A 58-year-old ‘brittle’ asthmatic is brought in to the hospital with shortness of breath. He is unable to speak and is starting to tire.
Clinical course
ABCDE
A : clear
B : RR 30 min-1, PEFR unrecordable, SpO2 85% on 6 L min-1 oxygen via Hudson mask
C : P 140 min-1, BP 100/60 mmHg
D : unable to speak and starting to tire
E : pale and clammy
What action will you take? 3

4. Case study (continued)
Arterial blood gas analysis:
Inspired oxygen 40% (FiO2 0.4) estimated
normal values
PaO mmHg > 75 mmHg on air
pH – 7.45
PaCO mmHg kPa 35 – 45 mmHg
Bicarbonate 20 mmol L – 26 mmol L-1
Base excess -4 mmol L-1 +/- 2 mmol L-1
What are you going to do now? 4

5. Case study (continued)
Clinical course
The patient’s trachea is intubated and shortly afterwards there is no palpable pulse
What will you do now?
Considerations for ventilation? 5

6. Case study (continued)
Clinical course
The patient’s trachea is intubated and shortly afterwards there is no palpable pulse
What are the most likely reversible causes and how would you assess for and treat them? 6

7. Any questions?

8. Advanced Life Support Course Slide set
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© Australian Resuscitation Council (June 2016)