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Moderate acute asthma — RACP Paediatrics MCQ

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EasyRespiratoryModerate acute asthmaRACP Paediatrics

A 6-year-old presents with acute asthma. He has widespread wheeze, SpO2 94%, and moderate accessory muscle use. He can speak in short sentences. What is the most appropriate initial bronchodilator treatment?

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Correct answer: A — Salbutamol 6 puffs via spacer

For moderate acute asthma in children, initial treatment is inhaled salbutamol 6 puffs (600 mcg) via pMDI and spacer every 20 minutes for the first hour. Nebuliser use is reserved for severe or life-threatening asthma. Oral prednisolone should be given concurrently.

Reference: RCH Melbourne – 2023 – Acute Asthma CPG; National Asthma Council Australia – 2022