December 11, 2010

Patient with Acute Exacerbation of Asthma who is at high risk of asthma related death

Asthma Exacerbation definition

Exacerbations of asthma (asthma attacks or acute asthma) are episodes of progressive increase in shortness of breath, cough, wheezing, or chest tightness, or some combination of these symptoms. Respiratory distress is common.[GINA Reports 2007]

High risk patient

a) History of near fatal asthma (intubated, mechanical ventilation, admission to intensive care unit)
b) Exacerbation requiring hospitalization or emergency care visit in the past year
c) Currently using or stop oral glucocorticosteroids
d) Not currently use inhaled glucocorticosteroids
e) Highly dependent on rapid acting beta 2 agonist (more than one canister of salbutamol or equivalent monthly)
f) With underlying psychiatric disease or psychosocial problems (including use of sedatives)
g) Non compliance to asthma medication plan


Global Initiative For Asthma, "Global Strategy for Asthma Management and Prevention updated 2007",


  1. Is there any explanation on how to advice patient's mom to use aerochamber..?

    I heard that it cannot be washed, need to change every 2 years etc.

    Is this what causes children to suffer more from asthma?

  2. You can check my OSCE question on aerochamber which i posted few months ago..

    the answer is here

    i'm not sure about your statement. here, we advise pt to wash it with warm water..

    whether it cause pt to suffer more from asthma, that thing we need to go back to the basic pathophysiolgy of asthma which is hyper responsiveness of airway causing the bronchoconstriction..


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