You are called to the emergency department to see a young woman with an acute exacerbation of asthma: she's had a nebuliser of salbutamol and is still struggling to breathe, using her accessory muscles and looking tired. What should you do next?
Aug 22, '11
Oxygen, stacked nebs, IV solumedrol, ABG, portable CXR.
Aug 23, '11
Leave because I don't work in the ED!
Aug 28, '11
Mg drip. Intubate. Paralytics if really that bad.
Sep 10, '11
Continuous albuterol, tele, oximter. ABG. When the abg looks bad and the patient looks bad, give them some time. When the abg starts to improve, that's when you intubate.
Sep 13, '11
Standard 3 back to backs, mag bolus, iv solumederol, sometimes fluid bolus to prevent hypotension from mag and then double strength or single strength continuous. Take care of this all the time Intubation is last resort and rarely seen, plus dont forget to check for allergies possible epi shot once in a blue moon