Question

A 19-year-old man with severe acute asthma presents with exhaustion, a silent chest, SpO₂ 88% on 15 L oxygen via non-rebreather mask, and PCO₂ rising to normal on arterial blood gas. He has had continuous nebulised salbutamol and IV hydrocortisone. What is the most appropriate next step?

Accepted Answer

Arrange immediate endotracheal intubation and mechanical ventilation

Answer

Continue current therapy and observe

Answer

Add IV aminophylline and avoid escalation

Answer

Give a trial of oral prednisolone and discharge if improved

Answer

Start long-term theophylline

Practice question

A 19-year-old man with severe acute asthma presents with exhaustion, a silent chest, SpO₂ 88% on 15 L oxygen via non-rebreather mask, and PCO₂ rising to normal on arterial blood gas. He has had continuous nebulised salbutamol and IV hydrocortisone. What is the most appropriate next step?