Yes
Consider NIV. Complet Prescription Chart for Acute NIV
No
O2 to maintain Sats 94% - 98%
Administer nebuliser using oxygen
Yes
IV Hydrocprtisone 200mg via slow IV bolus
If NBM or vomiting continues further doses of
hydrocortisone are required (50-100mg four
times a day, but dependent on patient/clinician).
No
Yes
Allergic to Doxycyline or Tetracyclines?
Yes - Check next allergy
No - Doxycyline 100mg PO BD (Unless received in last 2 weeks)
Check appropriateness of
antibiotic treatment against
laboratory culture and
sensitivities when available
Allergic to Amoxycillin or Penicillins?
Yes - Check next allergy
No - Amoxycillin 500mg PO (Unless received in last 2 weeks)
Check appropriateness of
antibiotic treatment against
laboratory culture and
sensitivities when available
Allergic to Clarithromycin?
Yes - See Microbiologist
No - Clarithromycin 500mg PO (Unless received in last 2 weks)
Check appropriateness of
antibiotic treatment against
laboratory culture and
sensitivities when available
Discuss with Microbiologist
Yes
Follow Monitoring Recovery and Early Assisted Discharge Pathway
Monitoring Recovery and EAD PathwayNo
Yes
Omit loading dose
No
Commence IVAminophylline
Loading Dose: 5mg/kg IV over 20 minutes
If still unstable consider ceiling treatment