Question

A 19-year-old woman with severe asthma presents with life-threatening features: silent chest, exhaustion, SpO₂ 88% on high-flow oxygen and rising CO₂. She has been given maximal nebulised bronchodilators and IV steroids. What is the most appropriate next step?

Accepted Answer

Early involvement of intensive care and preparation for intubation and mechanical ventilation

Answer

Repeat nebulised salbutamol for several hours before considering intubation

Answer

Discharge with oral steroids once oxygen saturations improve slightly

Answer

Start high-dose oral theophylline only

Answer

Avoid intubation at all costs as it is contraindicated in asthma

Practice question

A 19-year-old woman with severe asthma presents with life-threatening features: silent chest, exhaustion, SpO₂ 88% on high-flow oxygen and rising CO₂. She has been given maximal nebulised bronchodilators and IV steroids. What is the most appropriate next step?