asthmaticus

definition
• asthmaticus is an acute asthma attack that is very severe, prolonged,
and does not respond to normal therapy adequately
epidemiology
• Status atshmatikus attacks 10% of the entire population in the United
States. Prevalence has increased 60% over the past 20 years. The
mortality rate due to the attack of the disease continues to increase
in direct proportion to the increase in incidence.
• The status of athsmaticus is often found in groups of people with low
socioeconomic levels. There is no significant difference when it
comes to race. The incidence is higher in groups of people who have
difficulty getting access to health services
etiology
• Infection
• excessive use of tranguilizer
• excessive use of nebulizers
• Dehydration
• increased adrenergic block and non-specific irritants
• hypersensitivity to penicillin.
pathophysiology
• Allergens enter the body -> stimulate plasma cells -> IgE -> A number
of mediators (histamine, neocotrients, platelet activation factors,
bradykinin etc.) -> Increased capillary permeability -> Production of
increased mucus (swelling of the bronchial mucosa and thickening
secretion) -> decreased bronchial diameter -> abnormal perfusion
ventilation -> hypoxemia and respiratory alkalosis -> acidosis
respiration
diagnosis
• Anamnesis : symptoms, treatment that has been used, treatment
response, time of occurrence and cause / trigger of the attack at that time
• physical examination : how to talk, Breath frequency, Use of breathing
muscles, Pulse, Blood pressure (pulsus paradoksus), wheezing
• Supporting investigation :
- in asthma attacks, APE should be examined before treatment, without
delaying treatment, this check is done if a tool is available
- Oxygen saturation with pulse oxymetry can be done if a tool is available.
- Examination of blood gas analysis is carried out if facilities are available.
Differential diagnosis
• Upper airway obstruction
• Foreign body in the airway
• COPD exacerbation
• Parenkimal pulmonary disease
• Vocal cord dysfunction
• Acute heart failure
• Acute kidney failure
management
Counseling and Education
• Improve physical fitness
• Quit smoking
• Avoid triggers in the everyday environment
Prognosis
• Ad vitam : Dubia ad bonam
• Ad functionam : Bonam
• Ad sanationam : Dubia ad bonam