ED nurse initiated Rx of the patient presenting with asthma


  • patients with asthma benefit from early salbutamol and steroid therapy
  • their length of stay in ED could be reduced and their symptoms partly relieved by nurse initiated ED Rx, although it is recognised that these presentations can be complex and warrant timely medical assessment to properly exclude important red flags.
  • the following is a suggested framework for ED's who have nurses accredited to undertake ED nurse initiated treatment including the ordering of pathology tests.

specific history and examination

specific nurse initiated Rx for hyperemesis

red flags to escalate medical referral

  • inability to talk through a sentence
  • hypoxia (SaO2 < 92% room air)

initial Mx

  • adults may be suitable for transfer patient to EOU after discussion with senior ED doctor
  • commence salbutamol inhalers as per protocol
  • oral prednisolone if patient has not had a dose that day
  • oxygen to keep SaO2 > 96%
  • if mod-severe asthma:
    • iv access
    • bloods for FBE, U&E, VBG
    • consider CXR to exclude complications or pneumonia
nursing/asthma.txt · Last modified: 2012/07/23 15:00 (external edit)