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Next steps in the ambulance

Breathing Difficulties

By now we can see that Fraser is very unwell. He has signs of low saturations 87%, tracheal tug, respiratory rate of 40 and a HR 140.

If you look back at the previous severity assessment slide then you will see that this is acute severe asthma.

Concerning features will include that the child has low saturations and appear to be unresponsive to the salbutamol nebulisers.

Just because it looks like a duck and quacks, doesn’t make it a duck! This is almost certainly severe asthma but there are other causes for severe respiratory distress associated with wheeze. Could this be anaphylaxis for example? If you think it is, what are you going to do?

Let us know what you think in the discussion below.

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Emergency and Urgent Care for Children: a Survival Guide

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