Life-Threatening Asthma

In this lecture, Dr. Haney Mallemat shared a harrowing experience faced by a former resident from a small critical access hospital, emphasizing the critical nature of asthmatic emergencies. Highlighting the unique challenges of such cases, Dr. Mallemat discussed the importance of avoiding intubation unless absolutely necessary, opting instead for continuous nebulization and appropriate medications like epinephrine.
Stressing the significance of patient stabilization and thoughtful interventions, he advocated for techniques like ketamine administration to alleviate patient anxiety and the use of Non-Invasive Ventilation to provide support while avoiding premature intubation. Additionally, he provided insights into post-intubation care, emphasizing the need for careful ventilation strategies and vigilance for complications such as pneumothorax.
Dr. Mallemat's lecture underscored the critical role of healthcare providers in effectively managing life-threatening asthma cases, urging swift and organized action in these challenging situations.
00:00 A Harrowing Morning Call: The Story Begins
00:22 The Critical Decision in a Small Hospital
00:48 The Intense Battle Against Asthma
02:53 Understanding Asthma: An Interactive Exercise
04:11 Advanced Treatment Strategies for Severe Asthma
08:06 The Art of Intubation in Asthma Cases
10:08 Post-Intubation Care and Ventilator Settings
13:47 Exploring Innovative Treatments and ECMO
14:45 When CPR Isn't the First Step: Handling Codes
15:44 Concluding Remarks: The Importance of Preparedness
Hashtags:
#CriticalCare, #EmergencyMedicine, #AsthmaManagement, #RespiratoryDistress, #LifeThreateningAsthma, #EmergencyVentilation, #PermissiveHypercapnia, #BronchospasmTreatment, #NonInvasiveVentilation, #IntubationGuidelines, #KetamineUse, #VentilatorSettings, #ExtracorporealCO2Clearance, #DynamicHyperinflation, #CriticalCareProtocols

[@jakepotter3868]

This post has perfect timing because I’m doing a paper on life-threatening asthma right now! Thank you!

[@CriticalCareNow]

Glad you enjoyed it

[@rachelshemtov3363]

Great lecture. A classic

[@joshmcgoo]

Sick asthma/copd patients are scary. Great video

[@CriticalCareNow]

Thanks. I appreciate you

[@hossammustafa3146]

Very useful talk. thank you. The Epi dose here, is it the same we use during a code ?

[@oliverolea9766]

Great talk. Good point on the epi drip. Other key points - I have used theophylline drip as an intervention to avoid intubation. I also like to get baseline lung sliding after X-ray so I know right away if patient goes south if there is a pneumo And yes the most impt settings on limit of pressure alarm and resp rate. I set my alarm limit to 70 or 80 put the rate to 10 and then get plateau. If plateau is good I go up on the rate in increments of 2. So i am titrating ventilation to lung compliance. All of this is on the first 5 minutes of intubation. Patient is still paralyzed from the roc rsi I just have them. And yes. When I doconnect we disconnect for 6-7 seconds with like 2 people pressing on the chest

[@CriticalCareNow]

You just gave a master class on resuscitating the asthmatic. Bravo

[@Sibtain_pulmcrit_tz]

Great talk. Lots of useful tips!

[@CriticalCareNow]

Appreciate that

[@orenkrimchansky]

Thanks bro. Great great talk.

[@CriticalCareNow]

Thanks!

[@akimbo5u]

Just had to place 2 patients with asthma on ECMO over the past week! Super scary indeed!

[@CriticalCareNow]

ECMO is amazing for these patients when you can’t ventilate

[@chaimasalatvx4007]

Giving peep counters beathing out? Isn't that the biggest paradox of the century? I've been always taught to peep to cancel out autopeep

[@Rebecca-zr3lu]

Blessings in an abundance of the faith. I salute you. 😘🙏Grace and peace be upon and unto you and to this place. God bless you. 🤍Thank you. Will you believe and receive Jesus Christ as your LORD and personal saviour??? I do. 😊

[@Bindhya.maharjan]

Sir, How long can we allow peak airway pressure of near 60 ? Or decrease the limit as early as possible?

[@geezeweezebabypls]

🎉🎉

[@CriticalCareNow]

Thank you

[@libyaup1205]

❤❤❤❤❤❤❤

[@CriticalCareNow]

Grateful

[@giacomodeluca5993]

I did not understand the first part of the code -> disconnect. Can you explain?

[@CriticalCareNow]

Look up dynamic hyperinflation for more info