Acute Asthma Attacks Orders - Adults

Page by: E.J. Mayeaux, Jr., M.D.
Louisiana State University Medical Center Shreveport, Louisiana

1. Theophylline level, ABG (and/or pulse ox), CBC.
2. Proventil 0.3 cc in 3cc Normal Saline q2 hrs per HHN (hand held Nebulizer) OR Proventil 0.15 in 1.5 cc NS q30 Min. x 3 followed by above.
3. Spirogram (may order them post every nebulizer tx on same graph paper).
4. IVF D5 1/2NS at TKO.
5. Amminophylline Loading Dose IVPB: WT(lb)/2.2 x 5.0 (desired blood level).
6. Amminophylline IV constant infusion (mg/hr): WT(lb)/2.2 x 0.5m.
7. Steroids - MUST be started early.
   Hydrocortisone 100 - 150 mg q8 Hrs.
   Solumedrol 10-40mg Q4-6 hrs - high dose = 30mg/kg Q4-6 hrs (2days max).
8. Old Chart.
• OPTIONAL ORDERS:
9. CXR - EPA/LAT if possible of infection.
10. Consider giving antibiotics on discharge.
11. Always give antibiotics (usually Ampicillin, Amoxicillin, or Doxycycline) to COPDers.