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EasyRespiratoryAcute severe asthmaca-mccqe1ca-rcpsc-em

A 34-year-old man with known asthma presents to the emergency department with severe dyspnoea. He is speaking in single words, RR 34 breaths/min, HR 120 beats/min, SpO2 88% on room air, and using accessory muscles. Peak expiratory flow is 30% of predicted. Which of the following is the most appropriate initial management step?

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