TREATMENT OF STATUS ASTHAMTICUS

TREATMENT AT HOME.
1.high concentration. Of oxygen through M.C mask.  2.Bronchodilator theraphy with one of the following :
-Salbutamol 5mg or terbutalin 10mg by nebuliser every 20 min for 3 doses.
-Salbutamol or terbutalin administered by metered dose inhalers.
-aminophylline 5mg/kg I.V over 20 min.
3.Corticosteroid theraphy.
-hydrocortisone sodium succincte 200mg I.V
-methyl prednisolone 125 mg i.v.

TREATMENT IN HOSPITAL.

1.High concentration oxygen.
2.Salbutamol 5mg or terbutalin 10mg by nebuliser every 20 min for 3 doses.
3.Subcutaneous or I.V administration of beta-2 agonist in patients who have excessive cough.
Adrenalin 0.2-0.5 mg as 1:1000 solution subcutaneous every 20 min.
4.Ipratropium bromide 0.5 mg together with salbutamol 5mg ,if patient does not respond in 15-20 min.
5.Aminophylline I.V if no responce to nebulised bronchodilator.
6.Corticosteroids
-hydrocortisone sodium succinate 200-500 mg intravenously.4 to 6 hourly.
-oral prednisolone, loading dose 40-60 mg and there after 20 mg 6 hourly.
7.Endo tracheal intubation And mechanical ventilation in case of respiratory failure, severe hypoxia,acidosis.
8.Non invasive ventillation using continuous positive pressure or bi -level positive airway pressure. It reduces the work of breathing.
9.70% helium with oxygen reduces airway resistance and improves efficacy of broncho dilators.
10.Response is assessed from patients distress, respiratory rate ,heart rate and serial artericl blood gas studies.