Sitting

Keep the airway open, if no perceivable air

movement support ventilation, intubate if necessary
(see also drugs step no. 3 & 4)

Oxygen 2-3 L/min with 40-50 psi If hypoxemia present

(humid and minimal pressure)

IV line Dextrose 5% 200 ml/hr (50 drops/mnt)

1. BRONCHODILATOR, option:
A. Ventolin nebule 0,2-0,3 ml in 3 ml NaCl via nebulizer (repeat every 15 mnt)
B. Bricasma inj - 1 amp SC/IM/IV (repeat SC amp every 2-4 hr)
C. Ventolin inhaler 2 puff
D. Aminophylline inj. 1 amp in 20 ml Dextrose 40% IV slowly within
15 mnt or 5-6 mg/kg IV in 100 ml diluent within 30 mnt

2. GLUCOCORTICOID, option:
A. Methylprednisolon (solu-medrol) 1 amp IV (then 20 mg/4-6 hr)
B. Dexamethasone (Oradexon) 1 amp IV

3. Adrenaline 1 : 10.000 - 1ml to 5 ml IV slowly, for severe asthma or no

perceivable air movement

4. Meylon inj 0,5 1 meq/kg BW IV slowly, for severe asthma or no perceivable

air movement

Monitor E.C.G., especially if the patient has been administered large amounts of bronchodilator

Adapt from New South Wales Ambulance Service Protocol, Current Diagnostic Therapy & Bethesda Hospital