Status asthmaticus
One of the difficult cases that I witnessed this week is concerning a patient who came to the doctor’s clinic and was being carried by the mother and two men. The mother reported that the patient was a known asthmatic patient. I was at the reception, and I had to call the doctor immediately. The doctor stated that he knew the patient because the patient had been coming to the clinic for checkup and treatment for about seven years now. On physical assessment, the patient seemed to be in great pain over the chest due to the difficulty in breathing. He had wheezing sounds, short, shallow breaths, and coughing (Baudin et al., 2017). Besides, there was heavy sweating, confusion, trouble in speaking, fatigue, and blue-tinted skin and lips.
Status asthmaticus is a medical emergency and rarely responds to usual asthma treatment, which makes it a hard condition to manage (Baudin et al., 2017). The doctor tried to nebulize the patient with salbutamol to help in opening the airway because it is a bronchodilator. After this, the patient was given epinephrine shot while resting on the bed, but all seemed to be in vain. The patient was also a high flow rate oxygen because, according to the pulse oximetry, the blood oxygen level was getting below 60 and could fluctuate between 54 to around 60. A repeat nebulization with albuterol was done, and the patient seemed to improve after the second nebulization. The patient was then referred to the nearby hospital for hospitalization to allow for further management of the condition.
Reference
Baudin, F., Buisson, A., Vanel, B., Massenavette, B., Pouyau, R., & Javouhey, E. (2017). Nasal high flow in management of children with status asthmaticus: a retrospective observational study. Annals of intensive care, 7(1), 55.