Action
- Give high-dose short-acting beta agonist (SABA) + ipratropium by nebulizer or metered-dose inhaler (MDI) + spacer every 20 min for first hour
- Administer first dose of IV corticosteroids immediately (Class I)
Decision
Reassess. Improved after 1 hour?
Yes
- Continue current therapy
- Make admit vs observation vs discharge decision <4 hours from arrival
- If stable in <4 hours and ready for discharge, refer to “mild” path for discharge planning
- If worsening, move to “severe” path
- (Class II)
No
- Admit to hospital or place in observation
- If worsening, move to “severe” path
