Wilderness and Rescue Medicine 8th Edition

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Wilderness and Rescue Medicine

can also generate significant lower airway inflam- mation and continued wheezing with exacerba- tions that may continue for several hours or days. Even if the initial attack is completely aborted, the risk of further exacerbations may warrant evacu- ation from the field. Ideally, anyone whose life you have just saved with epinephrine should receive early follow-up medical care. If the symptoms are under control, the evacuation need not be an emergency one. In settings where evacuation is unreasonably dangerous or impractical, prednisone can be continued daily for up to 5 days. One 10mg dose of dexamethasone should be effective for up to 3 days. The patient should continue to use their albuterol inhaler as needed.

Chapter 9 Review: Severe Asthma

• Asthma causes lower airway constriction and, if severe, respiratory distress and failure. • The Wilderness Protocol for severe asthma calls for 0.3 mg of epinephrine by intramuscular injection followed by albuterol by inhalation and 10 mg of dexamethasone orally or 40-60 mg of prednisone orally. • Following treatment, evacuation for medical follow-up is ideal. In high-risk and remote settings, continued monitoring and use of albuterol and prednisone for several days may be indicated.