Asthma SSOU Admission Guideline
Definition
A patient with working diagnosis of asthma who responds well to initial bronchodilator therapy
Admission Criteria
- Known or suspected asthma or bronchospasm
- Good response to ED treatment but requires a period of observation / treatment
Exclusion Criteria
- HR >120, RR >30 after initial treatment
- Sp02 <93% on air after Rx
- Any COPD or evidence of Respiratory failure
- Home oxygen
- Focal Lower Respiratory Tract Infection
- Previous ICU admit
- Other causes of bronchospasm likely
- Continuous bronchodilator (esp nebs ) required
Investigations
None specifically indicated
Suggested Medications
ALL PATIENTS MUST RECEIVE STEROIDS Drug Dose Frequency Route Salbutamol MDI 100mcg 12 puffs 1-2 hourly prn Spacer Prednisolone 1mg/kg to max 50 mg Daily for 3-5/7 PO Consider inhaled preventer Specific Observations report immediately to medical staff any of the following
- Patient complains of increasing respiratory fatigue
- Decreased Conscious State
- Decreased Sa02 despite treatment
Specific Management Issues
- Notify MO if Salbutamol required more than hourly
- Discharge with written asthma management plan
Discharge Criteria
- Improvement/ stabilisation in clinical condition
- Bronchodilator required less frequently than 3 hourly
- Suitable social situation
Hospital Admission Criteria
- Failure to stabilise or improve
- Persistent hypoxia ( SpO2 <93%)
- Persisting sleep disturbance due to asthma
- Development of fever
- Inadequate social support
