Table 75-15.

Hospital Discharge Checklist for Patients with Asthma Exacerbations

Intervention	Dose/Timing	Education/Advice	MD/RN Initials
Inhaled medications (MDI + spacer/holding chamber)    Beta2-agonist    Corticosteroids	Select agent, dose, and frequency (e.g., albuterol) 2-6 puffs q 3-4 hr prn Medium dose	Teach purpose Teach technique Emphasize need for spacer/holding chamber Check patient technique
Oral medications	Select agent, dose, and frequency (e.g., prednisone 20 mg bid for 3-10 days)	Teach purpose Teach side effects
Peak flow meter	Measure AM and PM. PFF and record best of three tries each time	Teach purpose Teach technique Distribute peak flow diary
Follow-up visit	Make appointment for follow-up care with primary clinician or asthma specialist	Advise patient (or caregiver) of date, time, and location of appointment within 7 days of hospital discharge
Action plan	Before or at discharge	Instruct patient (or caregiver) on simple plan for actions to be taken when symptoms, signs, and PEF values suggest recurrent airflow obstruction

Adapted from National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert Panel Report II: Guidelines for the Diagnosis and Management of Asthma (NIH Publication No. 96-4051). Bethesda, MD, US Department of Health and Human Services, National Institutes of Health, 1997.