Question

A 7-year-old boy with known asthma presents to the emergency department with 2 hours of wheeze and shortness of breath after a viral upper respiratory tract infection. He can speak in short sentences, has a respiratory rate of 32 breaths/min, oxygen saturation 95% on room air, and mild intercostal recession. Auscultation reveals widespread expiratory wheeze. What is the most appropriate initial management?

Accepted Answer

Administer 6 puffs of salbutamol via metered-dose inhaler and spacer, plus a single dose of oral prednisolone

Answer

Start continuous salbutamol nebulisation with supplemental oxygen and intravenous aminophylline

Answer

Give intramuscular adrenaline and lay the child flat

Answer

Provide humidified oxygen only and reassess in 30 minutes

Answer

Commence maintenance inhaled corticosteroid therapy immediately and review in 6 weeks

Practice question