Question

A 26-year-old man with a history of asthma presents with worsening wheeze and breathlessness over the last 6 hours. He is speaking in short phrases, respiratory rate is 32 breaths/min, pulse 120 bpm, oxygen saturation 92% on air, and peak expiratory flow is 45% of his best. There are widespread wheezes on auscultation. What is the most appropriate initial management?

Accepted Answer

Start high-flow oxygen, give repeated nebulised Salbutamol with Ipratropium, and administer oral or intravenous corticosteroids

Answer

Give subcutaneous Adrenaline and arrange immediate intubation

Answer

Give only oral Prednisolone and review in 4 hours

Answer

Start oral Montelukast and review in clinic

Answer

Discharge with an increased dose of inhaled corticosteroid only

Practice question