asthma management across ages acute asthma

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Asthma management across ages Acute asthma. What is the difference between acute and brittle asthma??. Asthma management across ages Brittle asthma. Brittle asthma. Asthma management across ages Brittle asthma. Its sudden No warning signs No time. . Asthma management across ages - PowerPoint PPT Presentation

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Asthma management across agesAcute asthma

What is the difference between acute and brittle asthma??

Asthma management across agesBrittle asthma

Brittle asthma

Asthma management across agesBrittle asthma

Its suddenNo warning signs

No time

Asthma management across agesBrittle asthma

Brittle asthma

Very sudden sever attacks of asthma without the usual warning signs

Those who under-estimate their asthma, seeking doctor too late or not at all

Known as (Fulminant)

Asthma management across agesBrittle asthma

Identify patients at risks of fulminant attacks Those with previous fulminant attacks Those with previous hospital admissions for acute

asthma Those who need regular courses of oral steroids

Asthma management across agesBrittle asthma

Local arrangements are made for immediate hospital admissions in the event of acute attack

Liaison between : Patient Patient's relatives PHC team Local A&E Dept. Local chest physician

Very clear understanding of what to do and when for all those involved

Asthma management across agesBrittle asthma

Underestimating asthma People who do not seek medical attention British Thoracic Association (Anonymous 1992) survey

of 90 asthma deaths

21/36 dead or dying on GP arrival 2/3 out of 34 died in transit or soon after arrival hospital 13 patient no medical help

Delay in treatment is an important cause of asthma deaths

Asthma management across agesBrittle asthma

Cause of asthma deaths?

Delay in treatment is an important cause of asthma deaths

Failure of patient to appreciate severity of attack

Adverse psychosocial factors in over 65% of deaths (Wareham et al 1993, Mohan et al 1996)

Asthma management across agesBrittle asthma

Underestimating asthma Adverse psychosocial factors associated with risk of developing near fatal or fatal asthma

Non compliance with treatment Psychological illness e.g. psychosis, depression Alcohol or drug abuse Childhood abuse Social isolation Domestic stress

Asthma management across agesBrittle asthma

Underestimating asthma

Patients at risk from their asthma:

Frequent asthma attendance at ER Previous admissions from asthma in the last year Use large amounts of bronchodilators Require > 3 different types of asthma medications Had near fatal episodes of asthma

Asthma management across agesBrittle asthma

Underestimating asthma

Health professional role:

Patient education Identify high risk Patients with severe asthma and have one or more

associated psychosocial factors are at risk of asthma death (BTS/SIGN 2004)