Asthma Exacerbation Protocol
Asthma is a chronic disease characterized by acute, episodic exacerbations typically caused by known triggers. All asthma patients are at risk for having a life-threatening acute exacerbation even if they have long symptom free periods. Symptoms of acute asthma include wheezing, shortness of breath, cough and chest tightness.
Some common triggers of acute asthma are environmental agents (mold, pollen, dust), exercise, stress, chemicals, smoke exposure, weather changes and viruses.
Many asthma patients have an asthma action plan that specifies how to respond to early symptoms of an acute exacerbation. Ideally, individualized asthma action plans would be readily available as part of a camper/staff medical record to optimize acute and chronic treatment.
- Evaluation and Treatment
- Immediately evaluate patient in health center
- Assess for signs of respiratory distress (tachypnea, wheezing, retractions, dyspnea, cyanosis)
- Take vital signs including oxygen saturation, if possible
- Apply supplemental oxygen for moderate to severe respiratory distress, color change, oxygen saturation < 94% and activate 911 for emergency transport.
- For all other patients, administer albuterol via metered dose inhaler with spacer or via nebulizer
- Reassess clinical status, vital signs, and progression of symptoms every 15 minutes; patients with mild to moderate symptoms who demonstrate significant improvement should observed for at least 2 hours before return to activities; all others should be transported to the hospital for further evaluation and management
Consider administration of oral dexamethasone for all patients with an acute asthma exacerbation