1.Position and environment: take a sitting position and give back support, keep the room quiet and well ventilated, pay attention to relieving the patient’s anxiety and tension.
2.Ensure the respiratory tract is unobstructed and correct hypoxia.
(1) Remove sputum and assist in sputum removal and aspiration. Pay attention to the high flow of oxygen before and after aspiration.
(2) Inhale oxygen 4-6L/min and give appropriate humidification.
(3) Perform artificial or mechanical assisted breathing if necessary.
(3) Improve ventilation and reduce respiratory distress by pacifying and expanding the branches.
(1) 0.1% epinephrine 0.5mg by subcutaneous injection or isoproterenol 5-10mg sublingually, 3-4/d.
(2) Cure asthma 0.25mg or 0.5% albuterol 1mg, diluted and nebulized by inhalation.
(3) Aminophylline 0.25g plus 25% glucose injection 100ml IV, total amount should not exceed 1.5g.
(4) The early and adequate use of adrenocorticosteroids is the key to successful treatment. Hydrocortisone 100-400mg or dexamethasone 20mg is added to 500ml of liquid in a sedative drip every 6-8h, and can be switched to oral maintenance after 3d if the symptoms improve. The principle medication is used in about one week.
5.Correct dehydration and salt-base imbalance.
(1) Isotonic fluid IV 2000-3000ml/d, keep urine volume >1000ml/d.
(2) 5% NaHCO3 100-200ml IV.
(3) With urine should pay attention to timely potassium supplementation.
6, anti-infection should be high dose and combined application, pay attention to the selection of sensitive antibiotics based on drug sensitivity test.
Other treatment.
1.Prepare for emergency respiratory arrest, if necessary, take tracheal intubation or tracheotomy to save the patient’s life.
2. Closely observe the condition and medication, including the improvement of dyspnea, croup, heart rate, blood pressure, blood gas acid-base analysis and electrocardiogram changes, and provide timely emergency treatment.
3.Watch for complications such as spontaneous pneumothorax and mediastinal emphysema.
4.Ensure the effect of oxygen therapy and do the observation and care of artificial assisted breathing.
5.Stabilize the patient’s emotion, and provide prompt and orderly treatment.
6.Actively treat the cause and remove the triggering factors.