NGN Case Study: Pediatric Asthma Walkthrough

Severe pediatric asthma exacerbation from arrival through admission.

Peds asthma case tests severity assessment and treatment escalation.

Presentation

6 y/o known asthmatic. Wheezing, retractions, RR 40, SpO2 88%. Pre-hospital albuterol given without much improvement.

Recognize

Severe exacerbation. Failed pre-hospital treatment.

Action

Continuous nebulized albuterol + ipratropium. IV steroids (methylprednisolone). Magnesium IV. Oxygen. Consider epi IM. Possible BiPAP or intubation if worsening.

Evaluate

Decreased work of breathing, improved SpO2, audible breath sounds.

Discharge teaching

Asthma action plan. Spacer technique. Trigger avoidance. Follow-up.

Frequently asked

Silent chest, concern?

Yes, impending respiratory failure. Don't be reassured by quiet.

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