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EasyRespiratoryAcute asthma exacerbationuk-plab-1

A 24-year-old woman with a history of asthma presents to the emergency department with acute shortness of breath. She is speaking in short phrases, respiratory rate is 30/min, pulse 115/min, oxygen saturation 93% on air and peak expiratory flow is 40% of her best. She has already used her Salbutamol inhaler several times with little benefit. What is the most appropriate immediate treatment?

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