Immediate treatment
High flow oxygen via tight fitting face mask or nasal cannulae at sufficient rate to maintain oxygen saturations greater than 92%.
Give a trial of ß2 agonist
- salbutamol up to 10 puffs via spacer (given one puff at a time inhaled separately using tidal breathing) and face mask or nebulised salbutamol 2.5 mg
- repeat β2 agonist every 1–4 hours if responding
- if poor response:
- add 0.25 mg nebulised ipratropium bromide to each β2 agonist nebuliser every 20–30 minutes for 1–2 hours
Consider systemic steroids:
- oral prednisolone 10 mg daily for upto 3 days
Continuous close monitoring of the following is necessary:
- heart rate
- pulse rate
- pulse oximetry (1)
Reference:
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