Office Management of Asthma Exacerbation

Assess sx and severity. To ED if unable to speak full sentence, breathless at rest or drowsy or agitated, PEF < 50%, HR > 120, RR > 30 , O2 < 90. Start Albuterol Neb Q 20 min x 3 (Consider co neb with ipratropium) , oral prednisone 40 mg. If improved with PEF 60-80% and O2 > 94 Ok to go home. Continue with SABA Q 3-4 hours, ICS, oral steroids, and avoid triggers. Instruction to go to ED if worse.