Mon22November0200PM 3

A 4-year-old child presents to the Emergency department with a history of wheeze, shortness of breath and fever. There is a family history of atopy and a paediatrician has given the child a diagnosis of asthma.

In the Emergency department the child has oxygen saturations (SpO2) of 94% on high flow oxygen, is unable to complete sentences, has a pulse rate of 130 beats per minute and a respiratory rate of 35 breaths per minute. His current peak expiratory flow rate is 51% of predicted.

Which of the following is a feature of acute severe asthma for this child?

(Please select 1 option)

Pulse rate of 130 beats per minute

Oxygen saturations of 94% on oxygen

Unable to complete sentences Correct

Respiratory rate of 35 breaths per minute

Peak expiratory flow rate of 51% of predicted

Explanation

The British Thoracic Society defines acute paediatric asthma attacks as either 'acute severe' or 'life threatening'.

Acute severe criteria are:

Oxygen saturations less than 92%

Peak expiratory flow rate of 33-50% of predicted

Inability to feed or talk

Pulse rate of more than 125 bpm and respiratory rate greater than 30 breaths per minute for children over 5, and

Pulse greater than 140 bpm and respiratory rate greater than 40 breaths per minute for children between 2- and 5- years-old.

Reference:

British Thoracic Society. Asthma Guideline.

Answer Statistics

1

4%

2

12%

3

70%

4

6%

5

11%

Times answered: 303