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Life-threatening asthma — RACP Paediatrics MCQ

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HardRespiratoryLife-threatening asthmaRACP Paediatrics

A 10-year-old with life-threatening asthma (silent chest, SpO2 85%, exhaustion, poor respiratory effort) has not responded to continuous nebulised salbutamol, ipratropium, and IV hydrocortisone. What is the most appropriate escalation?

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Correct answer: E — IV salbutamol

IV salbutamol is indicated for life-threatening or near-fatal asthma unresponsive to inhaled bronchodilators. It is given as a loading dose then continuous infusion with cardiac monitoring. IV magnesium sulphate is an alternative or concurrent adjunct. PICU involvement is essential.

Reference: RCH Melbourne – 2023 – Acute Asthma CPG