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Immediate treatment

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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