Asthma Attack: Not just a routine call!

Zumbro Valley Emergency Nurses AssociationApril 9, 2014

Peer Review Disclaimer 

CONFIDENTIAL PEER REVIEW INFORMATION: These documents contain quality data and/or peer review

information and are privileged and confidential and subject to protections from discovery under applicable state law,

including without limitation, Minnesota Statutes §§ 145.61-.67; Florida Statutes §§ 766.101-1016,

395.0191,395.0193, and 395.0197; Arizona Revised Statutes §§ 36-445-445.04 and 36-2401-2404; Iowa Code § 147.135;

and Wisconsin Statutes §§ 146.37-.38. 

Panel IntroductionsEmergency Communications CenterTerry Paul 

Stewartville Fire DepartmentLisa JelinekJamey Kime

Gold Cross AmbulanceChris Evanson

Saint Marys Emergency DepartmentDr. Dennis Laudon

ObjectivesAfter this case review, participants should be able to:

● Discuss prehospital care of asthma attacks and identify 4 agencies involved in the described case

● Describe the pathophysiology of asthma

● Identify and describe 2 principles of ECMO

Emergency CommunicationsCenter

911 Call

Stewartville First Response

Gold Cross Ambulance

Young adult Hispanic female supine on a bedroom floor unresponsive with SFD performing CPR. Unknown downtime, but viable patient. SFD reports non compliant airway. Rescue inhaler laying on the floor. Reports of asthma history with patient.

Initial Assessment 0425

Pieces of the Puzzle

• Restore Pulses

• Control Airway

• Treat Underlying Causes

Goals

• Definitive Care

• IV 0429• 0.9% Sodium Chloride• EPI 1:10,000 x2

• Airway 0433• Suction• Intubation• Bag-Valve High Flow O2 • ETCO2

Treatment On Scene

• Cardiac Monitor 0427• Agonal

Still unresponsive. Change seen on monitor. Carotid pulse checked and present.

Ongoing Assessment 0441

Vitals:

BP 128/78 HR 117RR 16 Assisted SpO2 89%

Transporting to SMH 0450

Treatment During Transport

• IV 0456• 0.9% Sodium Chloride TKO• Sodium Bi-Carb 50 mEq

• Airway 0458• BVM High Flow O2• Monitor ETCO2 and

SpO2• Duo-Neb

Transfer of Care 0505

Met with ED staff in Critical Care. Explained what was going on and why. Start the arduous task of getting equipment back in order and typing the report.

Saint Marys Emergency Department