Home Management of Acute Asthma - Flowchart
Home Management of Acute Asthma - Flowchart Asthma Asthma
«Flowchart»

Assess Severity


Patients at high risk for a fatal attack require immediate medical attention after initial treatment.
Symptoms and signs suggestive of a more serious exacerbation such as marked breathlessness, inability to speak more than short phrases, use of accessory muscles, or drowsiness should result in initial treatment while immediately consulting with a clinician.
Less severe signs and symptoms can be treated initially with assessment of response to therapy and further steps as listed below.
If available, measure PEFR—values of 50%-79% predicted or personal best indicate the need for quick-relief medication. Depending on the response to treatment, contact with a clinician may also be indicated. Values below 50% indicate the need for immediate medical care.

Assess Severity


Patients at high risk for a fatal attack require immediate medical attention after initial treatment.
Symptoms and signs suggestive of a more serious exacerbation such as marked breathlessness, inability to speak more than short phrases, use of accessory muscles, or drowsiness should result in initial treatment while immediately consulting with a clinician.
Less severe signs and symptoms can be treated initially with assessment of response to therapy and further steps as listed below.
If available, measure PEFR—values of 50%-79% predicted or personal best indicate the need for quick-relief medication. Depending on the response to treatment, contact with a clinician may also be indicated. Values below 50% indicate the need for immediate medical care.

Assess Severity

Assess Severity


Patients at high risk for a fatal attack require immediate medical attention after initial treatment.
Symptoms and signs suggestive of a more serious exacerbation such as marked breathlessness, inability to speak more than short phrases, use of accessory muscles, or drowsiness should result in initial treatment while immediately consulting with a clinician.
Less severe signs and symptoms can be treated initially with assessment of response to therapy and further steps as listed below.
If available, measure PEFR—values of 50%-79% predicted or personal best indicate the need for quick-relief medication. Depending on the response to treatment, contact with a clinician may also be indicated. Values below 50% indicate the need for immediate medical care.


Patients at high risk for a fatal attack require immediate medical attention after initial treatment. Patients at high risk for a fatal attack require immediate medical attention after initial treatment.
Symptoms and signs suggestive of a more serious exacerbation such as marked breathlessness, inability to speak more than short phrases, use of accessory muscles, or drowsiness should result in initial treatment while immediately consulting with a clinician.
Less severe signs and symptoms can be treated initially with assessment of response to therapy and further steps as listed below.
If available, measure PEFR—values of 50%-79% predicted or personal best indicate the need for quick-relief medication. Depending on the response to treatment, contact with a clinician may also be indicated. Values below 50% indicate the need for immediate medical care.

Initial Treatment


Inhaled SABA: up to two treatments 20 minutes apart of 2-6 puffs by MDI or nebulizer treatments.
Note: Medication delivery is highly variable. Children and individuals who have exacerbations of lesser severity may need fewer puffs than suggested above.

Initial Treatment


Inhaled SABA: up to two treatments 20 minutes apart of 2-6 puffs by MDI or nebulizer treatments.
Note: Medication delivery is highly variable. Children and individuals who have exacerbations of lesser severity may need fewer puffs than suggested above.

Initial Treatment

Initial Treatment


Inhaled SABA: up to two treatments 20 minutes apart of 2-6 puffs by MDI or nebulizer treatments.
Note: Medication delivery is highly variable. Children and individuals who have exacerbations of lesser severity may need fewer puffs than suggested above.


Inhaled SABA: up to two treatments 20 minutes apart of 2-6 puffs by MDI or nebulizer treatments.
Note: Medication delivery is highly variable. Children and individuals who have exacerbations of lesser severity may need fewer puffs than suggested above.


To ED.


To ED.


To ED.


To ED.

End

End

End

Good Response

No wheezing or dyspnea (assess tachypnea in young children).

PEFR ≥80% predicted or personal best.


Contact clinician for follow-up instructions and further management.
May continue inhaled SABA every 3-4 hours for 24-48 hours.
Consider short course of oral systemic corticosteriods.

Good Response

Good Response

No wheezing or dyspnea (assess tachypnea in young children).

PEFR ≥80% predicted or personal best.

≥


Contact clinician for follow-up instructions and further management.
May continue inhaled SABA every 3-4 hours for 24-48 hours.
Consider short course of oral systemic corticosteriods.


Contact clinician for follow-up instructions and further management.
May continue inhaled SABA every 3-4 hours for 24-48 hours.
Consider short course of oral systemic corticosteriods. Good Response

Incomplete Response

Persistent wheezing and dyspnea (tachypnea).

PEFR 50%-79% predicted or personal best.


Add oral systemic corticosteroid.
Continue inhaled SABA.
Contact clinician urgently (this day) for further instruction.

Incomplete Response

Incomplete Response

Persistent wheezing and dyspnea (tachypnea).

PEFR 50%-79% predicted or personal best.


Add oral systemic corticosteroid.
Continue inhaled SABA.
Contact clinician urgently (this day) for further instruction.


Add oral systemic corticosteroid.
Continue inhaled SABA.
Contact clinician urgently (this day) for further instruction. Incomplete Response

Poor Response

Marked wheezing and dyspnea.

PEFR <50% predicted or personal best.


Add oral systemic corticosteroid.
Repeat inhaled SABA immediately.
If distress is severe and nonresponsive to initial treatment:


Call your doctor AND
PROCEED TO ED;
Consider calling 9–1–1 (ambulance transport).

Poor Response

Poor Response

Marked wheezing and dyspnea.

PEFR <50% predicted or personal best.


Add oral systemic corticosteroid.
Repeat inhaled SABA immediately.
If distress is severe and nonresponsive to initial treatment:


Call your doctor AND
PROCEED TO ED;
Consider calling 9–1–1 (ambulance transport).


Add oral systemic corticosteroid.
Repeat inhaled SABA immediately.
If distress is severe and nonresponsive to initial treatment:


Call your doctor AND
PROCEED TO ED;
Consider calling 9–1–1 (ambulance transport).


Call your doctor AND
PROCEED TO ED; PROCEED TO ED;
Consider calling 9–1–1 (ambulance transport). Poor Response