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Family Medicine
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Answer 3
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Administer oral systemic corticosteroids and continue treatment with albuterol in the ED.
The treatment of patients with moderate asthma exacerbations who have a peak flow (personal best) of 40% to 69% after the first hour of appropriate treatment includes oral corticosteroids and an hourly SABA (eg, albuterol) for 1 to 3 hours.1 The decision to admit to the hospital should be made if the patient has not responded well to this regimen within no more than 4 hours after presentation.
REFERENCE
1. National Asthma Education and Prevention Program. Expert panel report 3: guidelines for the diagnosis and management of asthma (EPR-3 2007). NIH Publication No. 08–4051. Bethesda (MD): U.S. Department of Health and Human Services; National Institutes of Health; National Heart, Lung, and Blood Institute; 2007. Available at www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed 22 Jul 2008.
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