Bet 2 Is Endotracheal Adrenaline Useful in Acute Asthma?

Epinephrine (adrenaline) is commonly used by paramedics in a range of clinical scenarios. Its role in cardiac arrest scenarios is well established, but the indications for use in acute severe or life-threatening asthma are less well defined. This article reviews the evidence for the use of epinephrine in acute severe asthma and uses a case study to highlight some of the potential side-effects that clinicians need to be aware of.

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Epinephrine and its use in acute life-threatening asthma in adults

Bhullar

Mellor

Hill

2011

Journal of Paramedic Practice

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Medication Regimens for Managing Acute Asthma

Maselli

Peters

2018

Respir Care

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Asthma exacerbation is defined as a progressive increase in symptoms of shortness of breath, cough, or wheezing sufficient to require a change in therapy. After ruling out diagnoses that mimic an asthma exacerbation, therapy should be initiated. Short-acting β agonists and short-acting muscarinic antagonists are effective as bronchodilators for asthma in the acute setting. Systemic corticosteroids to reduce airway inflammation continue to be the mainstay therapy for asthma exacerbations, and, unless there is a contraindication, the oral route is favored. Based on the current evidence, nebulized magnesium should not be routinely used in acute asthma. The evidence favors the use of intravenous magnesium sulfate in selected cases, particularly in severe exacerbations. Methylxanthines have a minimum role as therapy for asthma exacerbations but may be considered in refractory cases of status asthmaticus with careful monitoring of toxicity. Current guidelines recommend the use of helium-oxygen mixtures in patients who do not respond to standard therapies or those with severe disease.

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Bet 2 Is Endotracheal Adrenaline Useful in Acute Asthma?

Abstract: There is insufficient evidence to support the routine use of endotracheal adrenaline in patients with respiratory arrest secondary to asthma.

Cited by 2 publications

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Epinephrine and its use in acute life-threatening asthma in adults

Epinephrine and its use in acute life-threatening asthma in adults

Medication Regimens for Managing Acute Asthma

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