Since we're on the subject, I'm interested in how many are using multidose
combination therapy (albuterol plus atrovent) for moderately severe to
severe asthmatics in the ED during their first hour of treatment.
The literature appears to support its use, and we're trying to develop a
collaborative protocol which allows for that option.
The two options we're considering is adding 1.0-1.5mg atrovent to the first
hour's continuous albuterol, or completely taking the patient off from the
continuous albuterol intermittently during the first hour to give 1-3
individual atrovent nebs (0.5mg each) and then putting them back on.
Respiratory therapy is adamantly opposed to combining agents, and very
reluctant to give more than 0.5mg atrovent in the first 6hrs.
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