By rray, 25 April, 2023 Give abx x5 7 days Use controversial but indicated in pts who require ventilation invasive or not When indicated e g uarr sputum purulence volume dyspnea can darr recovery time hospitalization duration darr early relapse risk tx failure B duration 5 days
By rray, 25 April, 2023 Theophylline aminophylline not recommended due to side effects B Resp stimulants not recommended for acute resp failure
By rray, 25 April, 2023 Systemic steroids prednisone 40 mg day x5 days A Oral is as effective as IV nebulized budesonide more expensive may be alternative to PO in some pts Steroids uarr FEV1 oxygenation darr recovery time hospitalization duration use 5 days A Even short burst a
By rray, 25 April, 2023 Short acting BDs SABA albuterol levalbuterol MDI NEB SAMA ipratropium MDI NEB C Use NEB hourly x2 3 doses then q2 4h Continuous NEB not recommended Air driven NEB preferred vs O2 driven to avoid potential uarr PaCO2 Use standard COVID 19 precautions keep
By rray, 25 April, 2023 If non life threatening Supplemental O2 to target pulse ox 88 to 92 sat check frequent ABG VBG for uarr PaCO2 acidosis If uarr work of breathing or impaired gas exchange Consider ventilation NIV preferred if not contraindicated
By rray, 25 April, 2023 If life threatening acute resp failure oxygenate ventilate NIV preferred if not contraindicated target pulse ox 88 to 92 sat check frequent ABG VBG for uarr PaCO2 acidosis
By rray, 25 April, 2023 Oxygenate ventilate give short acting BDs admit to MICU if using NIV ventilator
By rray, 25 April, 2023 Oxygenate ventilate give short acting BDs admit to MICU if using NIV ventilator
By rray, 25 April, 2023 Test for COVID 19 w new or worsening resp sx fever loss of taste and or smell Positive SARS CoV 2 testing does not exclude the potential for other resp pathogens Consider chest CT to help distinguish COVID 19 effects from other causes of exac
By rray, 25 April, 2023 Consider DDx nbsp nbsp Most frequent pneumonia PE CHF nbsp nbsp Less frequent pneumothorax pleural effusion MI arrhythmias nbsp nbsp Test as appropriate CXR d dimer CT pro BNP BNP echo ECG troponin