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Here is a link to the webpage that has all our clinical guidelines of care including asthma/RAD.  We use continuous albuterol (20 mg) on children who initially score a 6 on the respiratory scoring tool for 1 hr duration.  The subsequent treatment depends on their follow up respiratory score, 9 or higher = 2nd hour and admission, 5-8 = 8 puffs, obs 1 hr, < 4 obs 1 hr/dc home.  We utilize this pathway in the ED as well as at our Urgent Care sites of which 2 are off-campus.

http://www.seattlechildrens.org/healthcare-professionals/gateway/pathways/

This webpage is open for anyone, all pathways are available for anyone to view and/or utilize.

Karen Kilian, ARNP
Urgent Care | Emergency Department
Seattle Children's
Past-President, Washington State Chapter NAPNAP
206-987-2599  OFFICE
206-469-0576  PAGER
206-729-3070  FAX
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OFFICE    4800 Sand Point Way NE, Seattle, WA 98105
MAIL      MB.7.520
WWW     seattlechildrens.org



-----Original Message-----
From: Pediatric Emergency Medicine Discussion List [mailto:[log in to unmask]] On Behalf Of Jim Naprawa
Sent: Wednesday, August 13, 2014 08:49
To: [log in to unmask]
Subject: Continuous vs. intermittent albuterol

We are looking to change the way we deliver albuterol to moderate asthma exacerbation patients from intermittent to continuous nebulizations.  Questions for the group:  1) what dose of albuterol do you use for continuous albuterol and how long (1, 2 hours) do you give before deciding on admission?  2)  How often are assessments made on patients who are on continuous (q 15 min, q 30 min)?
Thanks,
Jim Naprawa
Nationwide Children's Hospital
Columbus, OH

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