SAQ 239 – Paediatrics – acute severe asthma

An 8-year-old girl presents with her mother to the emergency department with a 2-hour history of shortness of breath and wheeze. She has asthma and has previously required both ward and ICU admission, both two years ago. Her usual medications are salbutamol (Ventolin) PRN and fluticasone propionate (Flixotide) 100 micrograms BD. She has received no prehospital care. Her observations are GCS 15, HR 120/min, RR 40/min, SpO2 93% on room air, temperature 37.0 C, moderate accessory-muscle use, and speech in phrases.

For each salbutamol delivery system shown, state one (1) key advantage and one (1) key disadvantage for this patient.

(Marked out of 6.0)

Delivery system	Pro	Con
MDI with spacer
Nebulised
Intravenous

/ 6

List two (2) medications you would use during the first 20 minutes. State the dose and route for each.

(Marked out of 6.0)

Medication	Dose	Route
1.
2.

/ 6

She becomes drowsy and exhausted despite initial treatment. Other than oxygen and salbutamol, list two (2) medications you would commence, including dose and route.

(Marked out of 6.0)

Medication	Dose	Route
1.
2.

/ 6

Total Score: 0 / 18

Percentage: 0%