The efficacy and safety of a continuous albuterol protocol for the treatment of acute adult asthma attacks

We performed a prospective study over a 6-month period to test the efficacy and safety of a continuous nebulized albuterol protocol for the treatment of acute adult asthma attacks. All patients 18 years or older presenting to the emergency department with acute asthma attacks were begun by the triage nurse on the protocol of three continuous albuterol (2.5 mg) nebulizer treatments. Pretreatment and posttreatment peak flow, respiratory rate, pulse, and blood pressure were documented and patients gave a pretreatment and posttreatment rating of the clinical severity of their attack using a (1 to 10) visual analog scale. In addition, all adverse effects were noted. Seventy-six patients were entered in the study. The average age was 44 years (range, 20 to 82 years). Pretreatment and posttreatment peak flow, respiratory rate, pulse, blood pressure, and clinical severity were compared using the paired t test. Patients showed statistically significant increases in peak flow (128 to 292; P < .0001) and statistically significant decreases in respiratory rate (27 to 20; P < .0001); pulse, 103 to 94 (P < .0001); clinical severity, 7.810 to 1.810 (P < .0001); and blood pressure, 14182 to 13277 (P < .001). Adverse effects were minimal. Two patients (2.6%) felt flushed, three patients (4%) felt jittery, and one patient (1.3%) had a sensation of palpitations. We conclude that a continuous nebulized albuterol protocol is both extremely efficacious and safe for the treatment of acute adult asthma attacks.