An algorithm for the use of intravenous salbutamol in children

Abstract

the evidence base for the management of severe or life-threathening exacerbations of asthma is not as strong as that for mild or moderate exacerbations. Despite this information deficit, intravenous (IV) salbutamol has become an accepted treatment option for children not responding to inhaled bronchodilator and corticosteroid therapy. Studies have shown that it is used in many centres in the UK replacing IV aminophylline, however, there is wide variation in dosing regimens and inconsistencies in practice. The authors audited their own prescribing practice and developed an algorithm-based approach to the use of IV salbutamol that includes patient selection and all aspects of prescribing, preparation, administration, monitoring and the requirements of the environment where care is delivered. It includes details of the IV salbutamol bolus and the infusion process, incorporating all available evidence. The algorithm provides guidance on IV salbutamol usage in children up to and including 18 years. The authors hope it will promote standardised practice, limit the opportunity for prescribing errors and highlight the need for a national paediatric study comparing IV salbutamol and IV aminophylline. It may also stimulate discussion on the IV salbutamol dosage used in adult practice.