Asthma in afya

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inflammation of large and small airways that become hyper-responsive, leading to broncho-constriction, oedema and mucus plug formation

||''PEFR & of predicted/best''|''Speech''|''RR''|''Pulse''|''Mx''|
|''Moderate''|>50%|Normal speech|<25|<110|nebulised (or spacer) salbutamol (4-6puffs interval 10-20 mins), if PEFR 50-75% - pred 40-50mg|
|''Severe''|33-50%|can't complete sentences|>25|>110|plus ... consider admission if no response after 20 mins, O2 to maintain sats 94-98%|
|''Life-threatening''|<33%|exhaustion, confusion, coma|silent chest / cyanosis / feeble resp effort / O2 sats <92%|brady, dysrythmia, hypotension|admit (via 999), nebulise - salbutamol + ipratropium, O2 (94-98%), pred or IV hydrocortisone (100mg)|

''Red flags''
Accessory muscles - sitting up, not sentances
Tachycardia (100), pulsus paradoxsus, wheeze, tachypnoea (25)
silent chest, drowsy (hypercapnia), tired and fearful 
PEFR <33% normal

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