Diferencia entre revisiones de «Acute asthma exacerbation»
(Created page with "==Work-Up== Order CXR if: 1. Fever 2. Worsening sx (return) 3. Poor response to Rx 4. 1st wheeze == == ==Treatment== (In order of severity) 1. Albuterol continu...") |
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==Work-Up== | ==Work-Up== | ||
Order CXR if: | Order CXR if: | ||
#Fever | |||
#Worsening sx (return) | |||
#Poor response to Rx | |||
#1st wheeze | |||
==Treatment== | ==Treatment== | ||
(In order of severity) | (In order of severity) | ||
#Albuterol | |||
#*continuous = 0.15mg/kg/hr (max 20mg/hr) | |||
#Atrovent | |||
#Steroids (solumedrol/prednisone/prednisolone/dex) | |||
#*2mg/kg (inptn = 1mg/kg Q6hrs; outpt burst = 1mg/kg x4dy) | |||
#*or dexamethasone PO 0.6mg/kg (max 16kg) 1st dose, 2nd dose 36hrs after | |||
#Magnesium 50mg/kg (max 2gm IV over 20minutes) | |||
#Epi (1:1000) 0.01mg/kg (max 0.5mg) Q20min x 3 SQ | |||
#*Terbutaline SQ = same as Epi (max 0.25) | |||
#*Caution in elderly/CHF | |||
==Disposition== | ==Disposition== | ||
*Peak Flow = (30 x age-in-yrs) + 30 | |||
Peak Flow = (30 x age-in-yrs) + 30 | *Severe = <50% predicted Peak flow | ||
*Severe = <91% SaO2 | |||
Severe = <50% predicted Peak flow | |||
Severe = <91% SaO2 | |||
Revisión del 17:04 2 mar 2011
Work-Up
Order CXR if:
- Fever
- Worsening sx (return)
- Poor response to Rx
- 1st wheeze
Treatment
(In order of severity)
- Albuterol
- continuous = 0.15mg/kg/hr (max 20mg/hr)
- Atrovent
- Steroids (solumedrol/prednisone/prednisolone/dex)
- 2mg/kg (inptn = 1mg/kg Q6hrs; outpt burst = 1mg/kg x4dy)
- or dexamethasone PO 0.6mg/kg (max 16kg) 1st dose, 2nd dose 36hrs after
- Magnesium 50mg/kg (max 2gm IV over 20minutes)
- Epi (1:1000) 0.01mg/kg (max 0.5mg) Q20min x 3 SQ
- Terbutaline SQ = same as Epi (max 0.25)
- Caution in elderly/CHF
Disposition
- Peak Flow = (30 x age-in-yrs) + 30
- Severe = <50% predicted Peak flow
- Severe = <91% SaO2
Source
Adapted from Donaldson, Rosen