Action
- Give inhaled short-acting beta agonist (SABA) by nebulizer or metered-dose inhaler (MDI) + spacer
- Administer first dose of oral corticosteroids (Class I)
Decision
Reassess. Improved?
Yes
- Consider initiating inhaled corticosteroids or adjusting current dose as indicated
- Continue treatment with inhaled short-acting beta agonist (SABA), 2-6 puffs every 3-4 hours, as needed
- Discharge home with:
- Continued oral corticosteroid therapy for 5 days or repeat dose of dexamethasone next day
- Clear and simple return precautions
- Reliable follow-up
- Instruction on proper technique for using inhaled medication with spacer
- (Class I)
No
Continue to “moderate” path
