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MediumEmergencyAcute severe asthmaca-mccqe1ca-rcpsc-em

A 6-year-old boy with known asthma presents to the emergency department with severe respiratory distress. He is speaking in single words, respiratory rate is 40 breaths/min, oxygen saturation 89% on room air and there is widespread wheeze with reduced air entry. What is the most appropriate immediate management?

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