I'm in the process of developing a new self management plan for children in secondary care where I work. While I have the majority of it together there is still one area I'm having a little difficulty with so wondered if you could help or point me in the right direction.
After looking at a variety of plans there is often advice for patients to start taking their SABA every 4 hours until symptoms have improved. Why is the advise for SABA use every 4 hours and not 4 hourly PRN? Once a patient has commenced 4 hourly SABA's how long do they take this for before either escalating treatment (oral steroids) or seeking medical review? I can understand this advise for the duration of a cold but unsure about advising patients to take their SABA every 4 hours due to increasing symptoms.
I've looked long and hard on the internet etc for answers to this but cannot find any. The asthma UK plan leaves all this blank and there is no specific advise re. this in the BTS/SIGN guidelines.
Any help with this would be greatly appreciated.
P.S. Our plan will be symptom based not PEFR based in line with the latest SIGN/BTS guidance.