Treatment
In mild attacks:
Broncho dialators
Salbutamol inhaler 2 to 3 puffs 20-30 minutes apart until when relief is obtained. Then give 4hourly for 3 days OR Salmeterol fluticasone inhaler (same dose)
Steroids
Beclometasone, fluticasone inhalers
In severe attack:
When you encounterSPO2 less than 90%, Severe dypnea, Severe chest pain,Severe DIB or Central cynosis admit the patient and provide:
Oxygen therapy 5L/min and maintain SPO2 between 94- 98%
IV hydrocortisone 200mg, 8hrly for 48 hrs
Salbutamol OR Ipratropium bromide nebulisation as a stat dose.
If the pt stabilizes give,
Prednisolone 1-2mg/kg once daily to complete 3 – 5 days of treatment
If attack is completely resolved continue with Salbutamol inhalation 2-4 puffs every 4 hrs for 24-48 hours and oral Prednisolone 1-2mg once daily to complete 5 days of treatment.