A 3- year old boy is brought to the casualty by his mother with progressive shoness of breath for 1 day. The child has history of bronchial asthma. On examination , the child is blue, gasping and unresponsive What will you like to do first ?

Ans. is 'b' i.e., Administer 100% 02 by mask o The symptoms given by the child shows that he is suffering from life threatening asthma. o Presence of any of the following indicates life threatening Asthma. a) Cyanosis b) Silent chest c) Poor respiratory effects d) Altered sensorium e) Exhauston, fatigue f) PEFR < 30 % of predicted and 02 saturation of < 90 % Management of life threatening asthma (status asthmaticus) 1) Immediate O2 inhalation 2) Injection of terbutaline or adrenaline (s.c.) 3) Inhalation of salbutamol or terbutaline and ipratropium 4) Injection of hydrocoisone 10mg/kg. o After the above-mentioned steps an arrangement is made to transfer the patient to ICU. o Now, it must be clear that the first step in cases of life threatening asthma is to administer 02, then medications (salbutamol & Terbutaline) Mechanical ventilation is indicated only if these measures fail and the condition of the patient fuher deteriorates.