Management of asthma exacerbations in children: Home treatment algorithm for clinicians

SABA: short-acting beta₂ agonist (quick-relief inhaler); MDI: metered-dose inhaler; LABA: long-acting beta₂ agonist; ED: emergency department.
* The severity of an asthma exacerbation is primarily determined by assessment of clinical findings. Several clinical asthma severity scores have been designed for use in the acute care setting to evaluate initial exacerbation severity, although there is limited evidence regarding their use in the home or office setting. Refer to UpToDate topic on asthma severity assessment for further details.
¶ Refer to UpToDate table of risk factors for a fatal asthma attack.
Δ Symptoms and signs suggestive of a severe exacerbation include marked breathlessness, inability to speak more than short phrases, use of accessory muscles, and/or drowsiness.
◊ Oral glucocorticoid may be initiated at home, if available, or in the ambulance.