For the dyspneic patient in extremis, suspect Asthma / COPD Exacerbation if:
- Wheezes, rhonchi, long expiratory phase
- Signs of Severe Exacerbation:
- Respiratory rate >30
- Retractions (use of accessory muscles)
- Signs of Life-Threatening exacerbation:
- Cyanosis
- Agitated
- Somnolent
- Call 911. Give O2.
- Albuterol nebulizer (continuous)
- Albuterol inhaler — 1 puff q 1 min.
-
If Deteriorates / Life-threatening:
- Epinephrine 1:1000 (in 1 ml vial) 0.3 – 0.5 cc sub-cut. q5min x 3 doses; OR
- EpiPen IM, repeat in 10 min.
See posting Acute Dyspnea – 1.