Professional Documents
Culture Documents
Asma Bronkial
dr. Marcella Deviana
Wahana IGD
IDENTITAS PASIEN
Nama Lengkap : Tn.M
Tempat/Tanggal Lahir : Tanjungpandan/17 Agustus 1963
Umur : 53 tahun
Jenis kelamin : Laki laki
Suku bangsa : Melayu
Agama : Islam
Alamat : Sijuk
Pendidikan : SMK
Tanggal masuk RS : 21 Februari 2017
ANAMNESIS
Belum dilakukan
Planning :
Elektrokardiograf
Rontgen thorax
Pemeriksaan laboratorium
Diagnosis
Asma bronkial
Obat pulang :
Salbutamol 3x4mg
Metil Prednisolone 3x2mg
Asma Bronkiale
Penyakit jalan nafas obstruktif kronis, intermiten dan
reversible dengan ditandai oleh inflamasi dan
peningkatan reaktivasi terhadap stimulasi tertentu.
Diagnosis
Pemeriksaan Pemeriksaan
Anamnesis Fisik Penunjang
Tanyakan sesaknya Tanda tanda vital Belum dilakukan
dari kapan, Pulmo : wheezing
Tanyakn onsetnya pada kedua lapang Planning :
bagaimana paru
Elektrokardiogram
Tanyakan keluahn
lain yang dirasakan Rontgen thorax
Tanyakan riwayat Cek Laboratorium
penyakit dahulu
Tanyakan riwayat
penyakit keluarga
Managing exacerbations in acute care
settings
INITIAL ASSESSMENT Are any of the following present?
NO
YES
Further TRIAGE BY CLINICAL STATUS Consult ICU, start SABA and O2,
according to worst feature and prepare patient for intubation
NO
YES
Is it asthma?
ASSESS the PATIENT Risk factors for asthma-related death?
Severity of exacerbation?
START TREATMENT
SABA 410 puffs by pMDI + spacer, TRANSFER TO ACUTE
repeat every 20 minutes for 1 hour CARE FACILITY
WORSENING
Prednisolone: adults 1 mg/kg, max.
50 mg, children 12 mg/kg, max. 40 mg While waiting: give inhaled
SABA and ipratropium bromide,
Controlled oxygen (if available): target O2, systemic corticosteroid
saturation 9395% (children: 94-98%)
IMPROVING
FOLLOW UP
Reliever: reduce to as-needed
Controller: continue higher dose for short term (12 weeks) or long term (3 months), depending
on background to exacerbation
Risk factors: check and correct modifiable risk factors that may have contributed to exacerbation,
including inhaler technique and adherence
Action plan: Is it understood? Was it used appropriately? Does it need modification?
Is it asthma?
ASSESS the PATIENT Risk factors for asthma-related death?
Severity of exacerbation?
START TREATMENT
TRANSFER TO ACUTE
SABA 410 puffs by pMDI + spacer,
repeat every 20 minutes for 1 hour CARE FACILITY
WORSENING While waiting: give inhaled SABA
Prednisolone: adults 1 mg/kg, max.
50 mg, children 12 mg/kg, max. 40 mg and ipratropium bromide, O2,
Controlled oxygen (if available): target systemic corticosteroid
saturation 9395% (children: 94-98%)
IMPROVING
FOLLOW UP
Reliever: reduce to as-needed
Controller: continue higher dose for short term (12 weeks) or long term (3 months), depending
on background to exacerbation
Risk factors: check and correct modifiable risk factors that may have contributed to exacerbation,
including inhaler technique and adherence
Action plan: Is it understood? Was it used appropriately? Does it need modification?