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Discharge - Asthma patient

Make disposition decision

  • Discharge – Mild/moderate asthma meeting discharge criteria*

  • Ward admission – moderate - severe asthma, asthma with risk factors for poorer outcome

  • HDU/ICU referral – severe/life-threatening asthma, those requiring ventilator support

* FEV1> 75% predicted (or best), symptoms no longer significant, patient on reducing amounts of salbutamol no more than 3-4 hourly, ideally daylight hours

Discharging the asthmatic patient from ED

Prior to discharge patients should:

  • Indicate preparedness and ability to monitor and manage their asthma at home

  • Demonstrate appropriate inhaler technique in the ED with the use of a spacer

Understand and be supplied with a written symptom based asthma action plan.

  • Have clear written and verbal instructions on when to return to ED during an exacerbation

  • Ensure GP follow up within 24-48 hours from discharge

  • Be provided with a discharge letter documenting ED care and a home management plan

  • Have appropriate discharge medications (and consider a spacer):

    • Prednisolone 37.5-50mg/day for 5 days with regular reviews

    • Regular inhaled preventer

    • Adequate supply of a prn inhaled reliever

  • Be offered education on any of the issues above

Further resources

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