Question: Why did the dosing of salbutamol change by 100 mcg per administration? I am all for evidence-based changes to our protocols, but why such a small change? Surely the extra 100 mcg wasn't hurting anyone.

 In a similar question about salbutamol, we answered:

This decision was made to be consistent with the dosing guidelines for bronchodilators produced by the Canadian Association of Emergency Physicians (CAEP). Since this is how the emergency departments manage acute exacerbations, we thought it would be wise to be consistent.

1. Hodder R, Lougheed MD, Rowe BH, et al. Management of acute asthma in adults in the emergency department: nonventilatory management. CMAJ 2009; 182:E55€“67.

The link to the appendix with the various dosing strategies can be found on-line here: "http://www.cmaj.ca/content/suppl/2009/10/26/cmaj.080072.DC1/non-mcivor-1-at.pdf".

Additionally, the dosing regimen allows for multiple repeats of salbutamol, so no, harm from the "extra 100mcg" was not the reason the dosing regimen was changed.

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