Magnesium Sulfate for Acute Asthma Exacerbation

Intravenous magnesium sulfate given as a single dose of 1.2 g or 2 g over 15 to 30 minutes improves lung function and reduces the risk of hospital admission in adults with acute asthma exacerbations that have not resolved with current first line treatments.

Coke Bottle named Asthma

Metered-dose inhalers with a spacer can perform at least as well as nebulisation in delivering beta-agonists in children with acute asthma. Salbutamol has systemic side effects – tremor and increased pulse rate were more common when using nebulisers.

The Crashing Asthmatic

In severe life threatening asthma…adrenaline and magnesium helps your patient breath in the salbutamol…

Mild to Moderate Acute Asthma Attack…

Most DO NOT need a chest X-ray performed and a high WBC is common as a result both of stress as well as steroid use NOT A SIGN OF INFECTION so DON’T order labs or give antibiotics unless there are other features of infection.

Magnesium sulfate for moderate to severe asthma exacerbation

If inhaled salbutamol and iprotropium (remember, double nebs decrease the risk of admission) plus systemic glucocorticoids don’t help, give IV Magnesium sulfate 50 mg/kg IV over 20 minutes (max dose 2 grams, use this dose for adults)

Heroic Medical Measures in the Crashing Asthmatic

Pre-oxygenate your patient with high flow nasal cannula at 20 – 30 LPM Next consider using IM Epinephrine 0.3 – 0.5mg of 1:1000. Severe asthmatics will have a hard time getting inhaled beta agonists into the small airways, but parenteral epinephrine will get into the circulation and get to where it needs to provide support. […]

Emergency Medicine Kenya Foundation

Join Our Newsletter

Please complete this form to create an account, receive email updates and much more.
Contact Email *
First Name *
Last Name *
Facility or Organisation *
Designation or Occupation *
County or City *
Country *
Mobile number 
*
*Required Fields
I agree to the Privacy Policy and Terms of Use. It is our responsibility to protect your privacy and we guarantee that your data will be completely confidential.
Strengthening emergency healthcare systems in Kenya to save lives.