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Immediate treatment

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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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