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Publication Date

10-2016

Disclaimer

These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly, these guidelines should guide care with the understanding that departures from them may be required at times.

Objective of the Guideline

The objective of this guideline is to standardize the care of children seen on the inpatient units for asthma.

Target Users

Providers, staff nurses, and respiratory therapists caring for children with asthma on the inpatient units.

Clinical Questions Answered by Guideline

1. What level of oxygen saturation was used as a cutoff for initiation of supplemental oxygen for subjects in studies of asthma exacerbations?

2. What are the maximum doses of continuous albuterol?

3. In the child hospitalized with an asthma exacerbation, should intravenous fluids be routinely administered?

4. In the child hospitalized with an asthma exacerbation, should intravenous magnesium sulfate be used to improve pulmonary function?

5. In the child hospitalized with an asthma exacerbation, should more than one treatment with intravenous magnesium be given?

6. In the child hospitalized with an asthma exacerbation, should albuterol be administered by nebulizer or metered-dose inhaler (MDI) and spacer to improve pulmonary function?

7. In the child hospitalized with an asthma exacerbation, should methylprednisolone/prednisolone/prednisone vs. dexamethasone be used to improve pulmonary function?

8. In the child hospitalized with an asthma exacerbation, should inhaled steroids be initiated during an asthma exacerbation to improve pulmonary function or should inhaled corticosteroids be continued if the treatment is included on the child’s home Asthma Action Plan?

9. In the child hospitalized with an asthma exacerbation, should positive expiratory pressure (PEP) therapy be used?

10. For the child who has had > or = to four ED/UCC/inpatient episodes in the last 12 months (including the current visit), what is the efficacy of consulting:

  • Allergy, Asthma, Immunology OR Pulmonary Medicine?
  • Social Services?
  • Environmental Health?

Keywords

Asthma; Inpatient

Disciplines

Pediatrics

Comments

NOTE: Under Revision Based on AAP Guidelines

Asthma—Inpatient

Included in

Pediatrics Commons

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