Treatment of asthma2
| Moderate acute asthma | Severe acute asthma (or no response to treatment in moderate asthma) | Life threatening acute asthma |
|---|---|---|
| Protect and maintain airway as necessary Position for comfort (usually sitting upright) Salbutamol 5 mg via oxygen driven nebuliser If PEFR>50–75% of normal, give prednisolone 40–50 mg orally Treat and leave if patient responds to treatment Arrange re-assessment, possibly by telephone, at a suitable time Consider referring to GP or specialist nurse for delayed follow up if patient requires further support or review of treatment | Oxygen via non-rebreathing mask* Repeat salbutamol 5 mg nebuliser at 5 to 15 min intervals until symptoms are controlled* Administer prednisolone 40–50 mg orally or hydrocortisone 100 mg IV Consider treat and leave if patient fully responds to treatment and has adequate carer support If discharged, arrange re-assessment, possibly by telephone, at a suitable time Refer to GP for immediate appointment | Oxygen via non-rebreathing mask* Start transportation to hospital Repeat salbutamol 5 mg nebuliser at 5 to 15 min intervals until symptoms are controlled* Administer prednisolone 40–50 mg orally or hydrocortisone 200 mg IV* Oxygen via non-rebreathing mask* Repeat salbutamol 5 mg nebuliser at 5–15 min intervals until symptoms are controlled* Ipratropium 0.5 mg via nebuliser (may be mixed with salbutamol) Consider intravenous crystalloids in the presence of dehydration |