Acute onset, wheezing and cough


• Albuterol-ipratropium nebulizer

• Methylprednisolone 125mg IV


• After 3rd nebulizer PF = 300

• Albuterol inhaler with spacer

• Prednisone 60 mg/50/40/30/20/10 then stop q day

• F/U PCP in 2-3 days for recheck


Matthew Hansen, MD Oregon Health & Science University

David Sheridan, MD Oregon Health and Science University


David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center

Douglas Baker, MD Johns Hopkins University School of Medicine

Mohamud Daya, MD Oregon Health & Science University

• Bronchospasm

Differential Diagnosis

• Pneumonia

• Bronchospasm

• Status asthmaticus

• Bronchitis

Patient Workup

• History • Physical exam

• Chest X-ray

• Peak flow meter

Editor’s Notes

Traditionally, peak flow should be measured with the patient standing up. Peak flow measurement is compared to height-linked norms. Patients with chronic asthma should develop normative values at home. Baseline peak flows when the child is well can be helpful with acute exacerbations as another measure of disease severity.

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