Question

As an established patient who has a history of asthma arrive to the clinic you notice that they do not seem like themselves and make them aware that the provider is running a little behind. In the waiting room they are coughing quite a bit and seem restless. Should you be concerned? Why or Why not? Should anything be done immediately?

Answer 1

Yes, we should concern about the condition of the patient and we should immediately try to contact the doctor. If we are unable to contact the doctor to explain the symptoms , clinical condition of the patient and progression of any respiratory distress , first we should check the vitals ( saturaration levels SPO2, RR,HR,BP, Temperature) and respiratory distress severity (wheezing, ronchi, Subcostal retraction, suprasternal retractions, nasal flaring, grunting, work of breathing) assessment ... as an known case of asthma may be it is an acute exacerbated condition... initial assessment ( able to speak or not; mental status , severity level), ask about medication history, Drug allergy, Other medical conditions like Hypertension,Diabetes, any comorbid diseases, smoking history , family history, we should know about regularity in medication intake ... and ask about any fever history , throat pain, anosmia and other symptoms like loose stools , in view of COVID -SARS 2 pandemic to rule out it.... if patient having severe respiratory distress or desaturation without any COVID-SARS 2 symptoms , after explaining clinical condition to the patient and attenders and after taking concern for immediate management of disease we should start immediately medication for asthama, previously using medication for asthama medications like antiasthamatics ( bronchiodilators,inhalers, nebulisations, corticosteroids ) and start oxygen therapy with nasal prongs to stabilise the patient.... with taking all precautions and protective equipment like PPE and kept isolation (respiratory unit) if any respiratory symptoms or other symptoms typical of SARS COVID-2... later if patient stabilised and symptoms relieved we should inform to the doctor after arrival about everything regarding clinical condition and immediate management given to the patient... if condition is critical or severe respiratory distress or patient may need higher support for RD, immediately referred to higher centre