1
.
PEF
>50%
predicted
or
best
2
.
PEF
60
-
80%
of
predicted
.
No
distress
,
Physical
exam
-
Normal
3
.
Clinical
Deterioration
,
Drowsiness
,
Confusion
or
Silent
Chest
4
.
PEF
>
60
-
80%
of
predicted
.
No
distress
,
Physical
exam
-
Normal
(
____________________
)
Give
high
dose
IV
Magnesium
2
mg
in
5%
Dextrose
over
20
min
.
Consider
intubation
(
____________________
)
Nebulise
with
Salbutamol
+
Ipratropium
bromide
every
20
mins
or
3
doses
for
1
hour
.
Give
oral
or
IV
systemic
corticosteroids
(
____________________
)
Nebulise
with
Salbutamol
+
Ipratropium
every
20
min
or
3
dose
for
1
hour
.
Give
IV
hydrocortisone
2
mg
/
kg
(
____________________
)
Discharge
hom
e