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Which of the following would you recommend as initial therapy for a patient admitted to the emergency department with acute airway obstruction (wheezing, cough, dyspnea, peak expiratory flow rate [PEFR] less than 60% predicted) ?
I. Assess dose-response of metered-dose inhaler (MDI) albuterol (up to 12 puffs) .
II. Provide up to three small-volume jet nebulizer (SVN) treatments with albuterol every 20 minutes.
III. Immediately begin continuous albuterol therapy at 15 mg/hr.
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