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Family Medicine


Answer 1
  1. Provide oxygen, check pulse oximetry, and administer 3 nebulized short-acting ß-blockers in 20-minute intervals. Appropriate interventions for mild to moderate asthma exacerbations include SABA therapy and oxygen to maintain oxygen saturation (Sao2) at 90% or greater.1 Systemic corticosteroids would be indicated if the patient had previously been on steroids, did not respond to initial therapy, or had signs or symptoms of respiratory distress. Additionally, inhaled ipratropium would be indicated for more severe exacerbations of asthma. Injectable ß2-agonists (eg, terbutaline) have not been demonstrated to have greater efficacy than inhaled ß2-agonists.1

    REFERENCE
    1. National Asthma Education and Prevention Program. Expert panel report 3: guidelines for the diagnosis and management of asthma (EPR-3 2007). NIH Publication No. 08–4051. Bethesda (MD): U.S. Department of Health and Human Services; National Institutes of Health; National Heart, Lung, and Blood Institute; 2007. Available at www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed 22 Jul 2008.

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