Asthma Case

A 14-year-old male with a history of poorly controlled asthma was transported to the University of Minnesota Masonic hospital by way of Maple Grove hospital with status asthmaticus on Wednesday, February 24th. The patient began having breathing difficulty on the eve of the 22nd. On the 23rd, he called his mother from school and stated that he “was having a hard time breathing”. Initially, the patient was brought to his allergist office, where his SpO2 was 84%. He was given albuterol and sent to Maple Grove hospital emergency department. There he was tachypneic with retractions, and his SpO2 dropped to 89% on room air. He received six back to back albuterol neb and was placed on 2 liters nasal cannula. His x-ray was clear bilaterally and his …show more content…
He was using abdominal muscles and had supraclavicular retractions. His lung sounds were diminished with intermittent expiratory wheezes. His vitals were: temperature 99.8 degrees Fahrenheit, 108/46 blood pressure, 144 heart rate, 25-35 respiratory rate and SpO2 of 89% on HFNC. His respiratory rate was elevated due to increased work of breathing, and his heart rate was elevated most likely due to previous continuous albuterol. He was neurologically intact and alert and oriented. His HFNC was increased to 20 liters per minute with an FiO2 of 50%. He was also started on methylprednisolone 15mg Q4 for inflammation.
The patient has a history of asthma and has been hospitalized twice for the condition, most recently two and a half years ago. His mother states his asthma hasn 't been a problem since that time, although says he has problems breathing normally in gym class. Around the same time 2.5 years ago, the patient had bronchitis and pneumonia, both of which improved with antibiotics. However, since that time his breathing has not returned to normal. The mother was unsure of what daily medications he takes at home, and says he lost his rescue inhaler, which he normally takes multiple times a