Asthma Management Handbook

Version 1.0 Errata

Major amendments (clinical corrections)

Page

Change in text

Rationale and correction(s)

Date

Giving bronchodilator treatment according to severity and age

Recommendation:
For patients with life-threatening asthma, deliver salbutamol via continuous nebulisation driven by oxygen until breathing improves, then consider changing to a pressurised metered-dose inhaler plus spacer or intermittent nebuliser.

Changed from:
For patients with life-threatening asthma, consider using continuous nebulisation until dyspnoea improves, then change to pressurised metered-dose inhaler plus spacer or intermittent nebuliser.

Wording amended for clarity:

Addition of ‘driven by oxygen’

Rearrangement of word order
22 May 2014

Giving bronchodilator treatment according to severity and age

Recommendation:
To deliver intermittent nebulised bronchodilators in a patient receiving oxygen therapy, use an air-driven compressor nebuliser and administer oxygen by nasal cannulae. Titrate to oxygen saturation target of 92–95% in adults or at least 95% in children.

Changed from:
To deliver nebulised bronchodilators in a patient receiving oxygen therapy, use an air-driven compressor nebuliser and administer oxygen by nasal cannulae. Titrate to oxygen saturation target of 92–95% in adults or at least 95% in children.

Wording amended to distinguish between intermittent and continuous nebulisation:

Insertion of ‘intermittent’
22 May 2014

Figure. Managing life-threatening acute asthma in adults and children

Instruction:
ADULTS AND ADOLESCENTS
Salbutamol 2 x 5 mg nebules at a time
Use oxygen to drive nebuliser*
Titrate oxygen to target SaO2 ≥92%

Changed from:
ADULTS AND ADOLESCENTS
Salbutamol 2 x 5 mg nebules at a time
Use air to drive nebuliser
Give oxygen via venturi mask and titrate to target SaO2 92–95%

Wording amended to correct and clarify delivery method:

Replacement of ‘air’ with ‘oxygen’

Deletion of ‘give oxygen via venturi mask

Replacement of target SaO2 92–95% with ≥ 92%

Addition of asterisk and note: Piped oxygen or an oxygen cylinder fitted with a high-flow regulator (>6 L/min)
22 May 2014

Table: Initial bronchodilator treatment in acute asthma (adults and children 6 years and over) 

Instruction:
Give salbutamol 2 x 5 mg nebules via continuous nebulisation driven by oxygen‡
Maintain oxygen saturations:
Adults: 92% or higher
Children: 95% or higher

Changed from:
Give salbutamol 2 x 5 mg nebules via continuous nebulisation‡
Start oxygen therapy if oxygen saturation <95% and titrate to target:
Adults: 92–95%
Children: 95% or higher

Wording amended to correct and clarify delivery method, and to revise oxygen target for adults accordingly:

Addition of ‘driven by oxygen’

Deletion of ‘Start oxygen therapy if oxygen saturation <95%’

Replacement of ‘92–95%’ with ‘92% or higher’
22 May 2014

Table: Initial bronchodilator treatment in acute asthma (children 0-5 years) 

Instruction:
Give salbutamol 2 x 2.5 mg nebules via continuous nebulisation driven by oxygen‡
Maintain  oxygen saturation at 95% or higher

Changed from:
Give salbutamol 2 x 2.5 mg nebules via continuous nebulisation‡
Start oxygen if oxygen saturation <95%
Titrate to 95% or higher

Wording amended to correct and clarify delivery method:

Insertion of ‘driven by oxygen’

Deletion of ‘Start oxygen if oxygen saturation <95%’

22 May 2014

Minor amendments

Minor errors (e.g. typographical errors) in the current version of the Handbook are corrected in the online publication as soon as identified. Any amendments that could affect the intent or meaning of the text will be flagged accordingly.

Amendments that relate to content in the Quick Reference Guide will be listed in the Errata below.

Quick Reference Guide Version 1.0 Errata

A small number of typographical errors have been identified since the Quick Reference Guide was printed.

These errors have been corrected in the online version. If you have a printed version, please amend your copy accordingly.

Page Location Correction Date
17 Figure D. Stepped approach to adjusting asthma medication in children Spelling mistake in steps. Text should read:
‘montelukast’
4 March 2014
17 Figure D. Stepped approach to adjusting asthma medication in children

Incorrect text in second step. Label should read:
'SOME CHILDREN Regular preventer'

3 April 2014
20 Table R. Reviewing and adjusting preventer treatment for children aged 6 years and over Text omitted in heading of final column. Heading should read:
‘No or partial response’
4 March 2014
26–27 Figure F. Managing acute asthma in children

Incorrect text in box Provide post-acute care.

First line should apply to parent (or carer)

Second line should read:
'Provide oral prednisolone for 3–5 days'. 

28 March 2014