• Asthma SSOU Admission Guideline


    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



    None specifically indicated


    Suggested Medications

    Salbutamol MDI 100mcg12 puffs1-2 hourly prnSpacer
    Prednisolone1mg/kg to max 50 mgDaily for 3-5/7PO
    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
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