A normal PCO 2 may herald impending respiratory failure. Oxygen may be needed to support patient and should not be withheld even to do a blood gas analysis. If severe asthma, consider cardiac monitoring. Beta-agonists are the mainstay of treatment. May give up to 4 treatments per hour.
Some studies suggest that continuously nebulized albuterol works better.
Can use nebulized albuterol almost continuously if needed. Tachycardia does not increase further after first several doses. May cause hypokalemia by shifting K1 intracellularly. Metered-dose inhaler by means of a spacer is just as good as nebulizer if you give about 6 to 8 activations by a spacer to equal one nebulized treatment. Reduces return visits, admission rates.