Treatment of mild to moderate acute asthma
To determine the severity of acute asthma, see Assessing severity of acute asthma. Summary of management of acute asthma provides a summary of management of acute asthma according to severity.
For a patient with mild to moderate acute asthma according to the initial rapid assessment, start treatment with salbutamol. Use:
salbutamol 100 micrograms per actuation, 1 actuation at a time via pMDI with spacer: asthma, acute: mild to moderate salbutamol
child 1 to 5 years: 2 to 6 actuations; repeat as required.
adult or child 6 years or older: 4 to 12 actuations; repeat as required.
Immediately after starting treatment, perform a secondary severity assessment to determine ongoing treatment.
All adults and some children with moderate acute asthma should also receive oral corticosteroid therapy as soon as practical (and at least within the first hour of presentation). See Corticosteroid therapy for acute asthma for indications and doses.
If symptoms improve or resolve, salbutamol can be used less frequently or stopped. Monitor the patient for at least an hour after symptom resolution in case symptoms recur.
If the patient worsens or does not have a rapid and marked response to treatment, escalate treatment to that recommended for severe acute asthma. If the patient is being managed in primary care, arrange transfer to a hospital.