Acute asthma treatment

Question 1

Severe or life threatening asthma (adults)

Answer 1

Start treatment immediately and call for hospital transfer

Question 2

Moderate cases (adults)

Answer 2

Can be treated at home or in primary care

Question 3

First line treatment for acute asthma in adults

Answer 3

• Oxygen therapy to maintain SpO2 at 94-98%
• Salbutamol inhaler (high dose) via spacer for moderate cases or via oxygen driven nebuliser for severe
• Oral coritcosteorids (pred) to reduce inflammation

Question 4

Additional treatments for acute asthma in adults

Answer 4

• Ipratropium bromide nebuliser for more severe cases
• Magnesium sulfate IV if symptoms dont improve with initial treatments
• Aminophylline IV for near fatal cases

Question 5

First line treatment for acute asthma in children 2+

Answer 5

• Oxygen therapy if SpO2 <94%
• Salbutamol inhaler (up to 10 puffs) via spacer for moderate cases or via oxygen driven nebuliser for severe cases
• Oral corticosteroid (pred) for 3 days. Repeat dose if the child vomits.

Question 6

Additional treatment for acute asthma in children 2+

Answer 6

Ipratropium bromide nebuliser with salbutamol
if symptoms persist.
Consider magnesium sulfate nebulisation if
SpO2 <92%.
For severe cases unresponsive to inhalers, IV
magnesium sulfate, salbutamol, or
aminophylline under specialist care

Question 7

Acute asthma treatment for children under 2

Answer 7

All cases in hospital

Oxygen therapy (94-98%)
Beta 2 agonists inhaler (salbutamol) add ipratropium bromide if response is poor
Oral pred for up to 3 days, adjusted based on response