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ModerateRespiratoryLife-threatening asthmauk-plab-1

A 35-year-old man with known asthma presents with acute breathlessness. He is unable to complete sentences, appears agitated and has a respiratory rate of 30 breaths/min. Oxygen saturation is 88% on room air, pulse 132 beats/min and peak expiratory flow is 25% of predicted. On auscultation there is a silent chest. What is the most appropriate immediate management?

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