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Case Study of Acute Asthma: Susan's Journey Through Exacerbation and Management

This case study follows Susan, a 25-year-old unmarried mother with a history of severe asthma exacerbations. Initially admitted with a PEF of 150 L/min, her condition deteriorated, raising questions about GP actions, her asthma management, and discharge protocols. The narrative continues as Susan struggles with poor compliance and ultimately faces a fatal attack. Key questions investigate predictive factors of her death and the role of psychosocial factors in her treatment. This case underlines the importance of prompt assessment and self-management strategies in asthma care.

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Case Study of Acute Asthma: Susan's Journey Through Exacerbation and Management

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Presentation Transcript

  1. Susan Case study

  2. Part 1: the story so far… • 25-year old unmarried mother with history of acute severe exacerbations • PEF 150 L/min so admitted • At A&E, respiratory rate 30/min, pulse 145/min • Referred to ICU.

  3. Part 1: questions Did the GP act appropriately when consulted? Did the GP act appropriately when called? What factors in Susan’s history ring alarm bells?

  4. Part 1: questions How would you define Susan’s asthma attack? Was her management in A&E and as an inpatient appropriate? Were the discharge arrangements appropriate?

  5. Part 1: key point Assess and act promptly in acute asthma – admit patients with any features of a life threatening or near fatal attack, or severe attack persisting after initial treatment

  6. Part 2: the story continues… • Susan fails to attend clinic appointments and has poor compliance with therapy • Acute severe exacerbation in patient with history of previous such attacks and adverse psychosocial/behavioural factors • Fatal attack

  7. Part 2: questions Were there any factors that could have predicted Susan’s death? What could have been done about the risk to Susan? How did the actions of Susan’s mother contribute to the situation?

  8. Part 2: key points Assess and act promptly in acute asthma – admit patients with any features of a life threatening or near fatal attack, or severe attack persisting after initial treatment

  9. Part 2: key points • Self-management is effective – offer self-management to all patients with asthma; reinforce with a written asthma action plan that gives patient-specific advice on signs of deteriorating asthma and appropriate actions to take (see Asthma UK website, www.asthma.org.uk)

  10. Part 2: key points Healthcare professionals must be aware that patients with severe asthma and one or more adverse psychosocial factors are at risk of death

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