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stress at rest
ICU
Intubation?
Dexa
Heliax
Improved
Humidified air
wheezing component
Bronchiolitis
supportive tx: O2 ; suctioning
occasinally racemic epi
Astham (RAD)
For URI symptoms
Respiratory screen
If +
CXR
Parial Improvement
Steroids
IV Solumedrol
Orapred
inhalers
Albuterol/Atrovent doubles X 3
Albuterol continuous 10, 15 or 20
more than 1 hr
to ICU
Continue Albuterol continues
less than 1 hr
relapse less than one hour off
well for more than 1 hr off
to Floor
Albuterol/Atrovent single or double starting at q2/q1spaced to q4/q2 then q 6/q4
No improvment
Repeat CXR
Atelectasis
Consider Abx for atypical pneumonia
Chest PT, Spirometer
Improvment
Discharge
Consider referring for allergy
Consider Singulair
Consider adding steroids/long acting beta
Advir
Strength 500
Strength 250
strength 100
consider adding inhaer steroids
Pulmicort
Flovent
Consider adjusting the albuterol
Nebulizer
MDI spacer
Orapred 5 d
Complete improvement