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EasyRespiratoryAcute severe asthmaca-mccqe1ca-rcpsc-em

A 27-year-old man with moderate persistent asthma presents to the emergency department with severe dyspnoea and widespread wheeze after exposure to cat dander. He is unable to speak full sentences, respiratory rate is 32 breaths/min, oxygen saturation 90% on room air, and peak expiratory flow is 40% of predicted. What is the most appropriate immediate management?

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