Evidence-based On-call

Asthma exacerbation

Therapy

Give a beta-agonist ^a via an inhaler and holding chamber or via a nebuliser ^a

using air or oxygen ^d

Why?

Beta-agonists delivered by holding chamber are as effective as wet nebulisation . There is no clear increase in hospital admissions, time spent in the emergency department or need for more steroids. ^a
Salbutamol nebulisers are probably equally effective whether oxygen or air is used as the driving gas. Children who receive oxygen-driven nebulisers only have a rise in oxygen saturation whilst the nebuliser is working. ^d