In this video Dr. Roger Seheult of MedCram explains about an asthma case and treatment. The case involves a 25 year old female who is 4 months postpartum who presented to the emergency room with an increase in shortness of breath and is found to have an asthma exacerbation.
ABG in asthma exacerbation
He discusses ABG’s on this patient during the time she is in the emergency and how the ABG’s progress as she goes onto requiring a BiPAP machine and later intubation.
What happens in an asthma exacerbation?
He describes what occurs during an asthma exacerbation physiologically. In the lungs, there is inflammation in the bronchus (the tubes in the lungs) and the air has a difficult time coming out (ie on exhalation). This is due to the small muscles in these airways are contracted. There are two receptors found here, the muscarinic and beta receptor. The beta receptors cause muscle relaxation and you want to promote them with a beta agonist (enabler). You want to block the muscarinic receptors (which cause contractions) with an antagonist (blocker). The medications that are beta agonists typically have names that end in “ol,” whereas the medications that are muscarinic antagonists have names that usually end in “ium.”
The patient in this example continues to worsen and requires intubation and placement on a ventilator. Be sure to follow up with part 2 of this video series for further ventilator management in this asthma case.
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