Asthma

[akroeze]

Weight dependant...

< 30kg = 2.5mg Salbutamol (Albuterol)

> 30kg = 5.0 mg Salbutamol

Intubated patients < 30 = 6 puffs > 30 = 9 puffs (100mcg each)

We can repeat all of these 3 times continuously.

We don't carry Atrovent.

Further, provincial Symptom Relief protocols now recommend the use of an MDI with space in the doses you mentioned instead of nebulised as first choice for Tx of asthma.

[1EMT-P]

So they recommend using an MDI w/ Spacer instead of Nebulizers :?: That's interesting :!:

[AZCEP]

When the patient can hold, and use the device correctly, the MDI with spacer is a more effective method of drug delivery. It will produce a smaller droplet size that is absorbed faster than the same drug through an SVN.

[akroeze]

So they recommend using an MDI w/ Spacer instead of Nebulizers :?: That's interesting :!:

As the person stated above.

In addition, it decreases the chance of transmitting respiratory infections.

In fact, our protocols state absolute contraindication to nebulised meds if suspected or confirmed fever above 38.0C or if there is a declared respiratory outbreak. In these cases, we are to either use MDI with spacer or Epi SQ/IM if MDI with spacer is unavailable or the pt is unable to use properly.

[tniuqs]

Interesting topic.....will sit back and watch this one till to be sure, some serious "lack of" evidence based medical practice here. :twisted:

LMAO @ PVC!

[AZCEP]

Most of the treatment suggestions are based on best evidence.

Beta 2's, steroids, IV fluid replacement, and considerations of PPV are all backed with EBM. Magnesium hasn't been supported with great research, but when it is used, the pharmacology of it, can be justified.

[mediccjh]

2.5 mg Albuterol INH

125 mg Solu-Medrol IVP or IM

2G MgSO4 IV drip over 10-20 mins

0.25 mg Terbutaline SQ

EPI if really, really bad

[theotherphil]

Salbutamol 5mg nebulised with 6-8l/m O2, repeated as required until side effects become significant

In acute severe or life threatening asthma, nebulised Ipratropium 0.5mg should be given concurently with the first dose of Salbutamol. In acute asthma unresponsive to Salbutamol alone, a single 0.5mg dose of Ipratropium should be added to the second or later dose of Salbutamol.

Adrenaline 1:1000 for life threatening asthma with failing ventilations. 0.5mg IM initially, repeated after 5 mins if required.

Try to take best peak flow reading from three before and after treatment (easier said than done in some cases)

[Putte]

My ambulance district in Sweden: Ventoline (2,5mg/ml), steroids iv. Bricanyl (terbutalin) iv/sc/im if the patient is to tired to inhale ventoline, severe asthma adrenalin INH/sc/im/iv.

[becksdad]

2.5 mg albuterol

Douneb (combination albuterol/atrovent) if no relief

albuterol only may be repeated

solumedrol 125 mg IV

severe distress - Epi (1:1000) 0.3 mg SubQ

We have no protocol for Mag, but I have seen online med. direction OK its use. Most patients have bought a tube by the time a medic is looking for last ditch efforts, though.