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Near-Fatal Asthma — RACP Adult Medicine MCQ

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ModerateEmergency MedicineNear-Fatal AsthmaRACP Adult Medicine

A 35-year-old man presents with acute severe asthma. After nebulised salbutamol, ipratropium, IV hydrocortisone, and IV magnesium, PaCO₂ rises to 55 mmHg. What does this indicate?

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Correct answer: E — Impending respiratory arrest – near-fatal asthma

Rising PaCO₂ in acute asthma indicates respiratory muscle fatigue and impending respiratory failure. Immediate ICU transfer and preparation for intubation are required.

Reference: eTG – 2025 – Respiratory; GINA – 2024; ARC – 2024