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] less than 60% predicted)?
I. Assess dose-response of metered-dose inhaler (MDI) albuterol (up to 12 puffs).
II. Provide up to three small-volume jet nebulizer (SVN) treatments with albuterol every 20 minutes.
III. Immediately begin continuous albuterol therapy at 15 mg/hr.

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] less than 60% predicted)?
I.	Assess dose-response of metered-dose inhaler (MDI) albuterol (up to 12 puffs).
II.	Provide up to three small-volume jet nebulizer (SVN) treatments with albuterol every 20 minutes.
III.	Immediately begin continuous albuterol therapy at 15 mg/hr.

Quizplus · Accepted Answer

For acute airway obstruction, initial therapy often involves rapid-acting bronchodilators like albuterol. Both metered-dose inhalers (MDIs) with a spacer and small-volume jet nebulizer (SVN) treatments are effective for delivering albuterol in acute settings. Continuous albuterol therapy at 15 mg/hr is typically reserved for more severe cases and not usually the first step.

Which of the Following Would You Recommend as Initial Therapy