AKT-5991

AKT-5991

A 12-year-old girl is brought to see you during an out-of-hours shift.
She has a past history of asthma and usually takes salbutamol 100 mcg 2 puffs as required and beclomethasone 100 mcg twice a day. Her usual peak flow is 280. She has been on her current inhalers for over a year with no problems or flare-ups.Over the last two days she has become increasingly wheezy and this seems to have been triggered by an upper respiratory tract infection.
On examination, she has a temperature of 37.5℃, and has a widespread polyphonic wheeze on auscultation of the chest. Her peak flow rate is measured at 190. Oxygen saturations are 97% in air. There is no respiratory distress.
She receives six puffs of salbutamol via a spacer and following this feels much better, with a PEFR of 260. The child is monitored in the department for a further hour and remains stable with her chest sounding clear.
What is the most appropriate management plan?