Question

A 46-year-old woman presents to the emergency department with sudden onset severe chest tightness, wheeze and difficulty speaking in full sentences. She has a history of asthma. Peak expiratory flow is 30% of her predicted, respiratory rate 32/min, pulse 120 bpm and oxygen saturation 91% on air. According to BTS/NICE guidance, what is the most appropriate immediate treatment?

Accepted Answer

Nebulised Salbutamol plus high-flow oxygen, oral Prednisolone and consider Ipratropium and IV Hydrocortisone

Answer

High-dose inhaled Salbutamol via spacer only

Answer

Start antibiotics and discharge

Answer

Give a single dose of oral Prednisolone only

Answer

Refer for outpatient respiratory clinic review

Practice question