Case 1 - Initial examination of patient with acute asthma
Table 2: Management of acute asthma in the emergency room
|
Management of acute asthma in the emergency room |
| Oxygen |
| 8 L/min or more (when available) |
| B-Agonist |
| High dose salbutamol, nebulised or via metered-dose inhaler + spacer |
| Repeat every 10-15 minutes or continuously |
| Steroids |
| Hydrocortisone 250mg IV or prednisolone 50mg |
| If not responding |
| Add ipratropium to nebuliser solution; IV salbutamol 200ug bolus, then 10 ug/kg/h. Consider IV aminophylline |
| For cardio-respiratory arrest |
| IV adrenaline 0.5mg; intubation and ventilation |
| Monitor response |
| i.e. spirometry (peak flow) |
| Admission to hospital for severe attacks (discharge for moderate attack under certain circumstances) |
