Treatment of Asthma attack
zkadhem - 05-19-09 16:21

For any patient who presents to the ER with an attack of SOB and cough:
Sure at arrival we will take care of the ABC principle. Put pulse oxymeter. and do PEF.

- If at arrival PEF> 50% THEN the patient will be discharged home after treatment.
so,
Give him albuterol high flow nebulizer + O2. One dose every 30 minutes for 3 doses then re-evaluate the patient with another PEF, if PEF< 70% then use oral steroids and give him another 2 doses of albuterol high flow nebulizer this time one dose every hour. 2 hours later re-evaluate the patient if PEF> 70% then discharge him home on Albuterol high flow nebulizer and steroids high flow nebulizer(if he doesn't have the nebulizer home then you can prescribe the MDI steroid inhaler).

Now,
If at arrival the PEF was<50% then he will be admitted(most likely).
Start albuterol high flow nebulizer with O2, Ipratropiom high flow nebulizer and IV methylprednisolon.
After 3 doses of albuterol (one dose every 20 minutes), i.e. after one hour re-evlauate the patient with PEF. If PEF is < 50%......> give another 2 doses of bronchodilater , 1dose/hour. Then 2 hours later also do PEF if still no improvement then check his ABG.
If PaCO2>40 THEN ADMIT TO THE ICU[/b]

[b]However if the patient showed improvement and response to the treatment and his PEF now is > 50% then admit him to the ward.