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Asthma cardiac arrest — DIPIMC MCQ

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HardResuscitationAsthma cardiac arrestDIPIMCDipIMC

A patient with severe acute asthma is intubated and then arrests. Ventilation is difficult, airway pressures are very high and the chest is becoming progressively more distended.

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Disconnect the ventilation circuit to allow exhalation and consider bilateral thoracostomies

Explanation lettering: D = shown as A · A = shown as B · B = shown as D

In an asthmatic arrest, dynamic hyperinflation ('breath stacking') and tension pneumothorax are key reversible problems, so disconnecting the circuit to allow full exhalation and considering bilateral thoracostomies is the immediate action. Increasing the rate (B) or PEEP (E) worsens gas trapping. When ventilation becomes impossible in an asthmatic, let the air out and decompress the chest.

Reference: Resuscitation Council UK 2025 (special circumstances)