Treatment of Acute Asthma in ER With Combination of Systemic Steroids and Inhaled Steroids

We assume that the combination of systemic steroids and inhaled steroid in the first hour of treatment in the ER will decrease the admission rate and improve faster the pulmonary function. 120 patients refferd to the ER due to asthma attack aged 18-60 with PFR \< 60% 0o predicted will participate in the study after giving informed consent. The usual treatment in the ER is inhalation of Beta 2 short acting and I.V solumedrol 120 mg . The study group will recieve in addition 3 inhalation of Budesonide 1000 microgram each during the first hour. The controlled group will recieve Nacl 0.9% PFR will be followed 0 30 60 120 min.