Which of the following would you recommend as initial therapy for a patient admitted to the emergency department with acute airway obstruction (wheezing, cough, dyspnea, peak expiratory flow rate [PEFR]

Question

Which of the following would you recommend as initial therapy for a patient admitted to the emergency department with acute airway obstruction (wheezing, cough, dyspnea, peak expiratory flow rate [PEFR] <60% predicted)?
1) Assess dose-response of metered dose inhaler (MDI) albuterol (up to 12 puffs).
2) Provide up to three small-volume jet nebulizer (SVN) treatments with albuterol every 20 min.
3) Immediately begin continuous albuterol therapy at 15 mg/hr.

Quizplus · Accepted Answer

Options 1 and 2 are appropriate initial therapies for acute airway obstruction. Metered dose inhalers (MDIs) with a spacer or nebulized treatments are both effective for delivering fast-acting bronchodilators like albuterol. Option 3, continuous albuterol therapy, is typically reserved for more severe cases and not usually the first step.

Which of the Following Would You Recommend as Initial Therapy