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Had a pretty good asthma exacerbation today, 11yo female with global inspiratory and expiratory wheezing in all fields. Albuterol rescue inhaler used twice prior to arrival and we provided 2 additional nebulized albuterol treatments along with 100mg of Sol-Medrol. The albuterol had zero effect on lung sounds or the patient's work of breathing (which oddly was not particularly great). Generally in this scenario I would think a duoneb would be the next step to try and alleviate the bronchospasm.
However, both protocols that I work under do not allow for Atrovent use in patients 13 years or younger. I can find nothing to support this, but did find a half decent study showing some benefit in using it. So what gives? Are we just behind?
However, both protocols that I work under do not allow for Atrovent use in patients 13 years or younger. I can find nothing to support this, but did find a half decent study showing some benefit in using it. So what gives? Are we just behind?