Acute exacerbation of asthma
Summary of Case (max 500 words)
A 6 year old girl was brought into hospital with a 24 hour history of having a worsening cough and a runny nose. In the last four hours her parents had noticed that she was very quiet and her breathing had become rapid and wheezy. She has a history of viral induced wheeze which had been managed in the community with inhaled salbutamol. Between these episodes she has often woken up coughing at night. Her mother who brought her in, stated that the family has moved into a new house two days ago.
On examination her respiratory rate is 60 breaths / min (tacypnoeic), SpO2 is 91% on room air, pulse is 150bpm (tachycardic) and temperature is 37.2°C. She is sitting upright and refuses to lie down. She can only talk in short sentences. She has subcostal and intercostal recession as well as tracheal tug. Auscultation reveals decreased entry and expiratory wheeze throughout her chest. Her heart sounds are normal and her abdomen is soft, with normal bowel sounds. She is not coryzal and her throat and her ears are not erythematous. Her GCS is 15/15.
She was initially started on high flow oxygen via a non re-breather mask and then transferred to nebulised salbutamol driven with oxygen .
Reflective case study
Finish summary of case (make it up) and write a short reflective commentary on the case thinking about the following questions.
What have you learnt from the case? What else have you learnt about other than the basic medical case – how does the case relate to the GMC Outcomes for Graduates? Why is communication with the patient important in this case?
How will your communication between Primary and Secondary care impact on the ongoing care for this patient? So what personal learning needs have you identified from this case?
