Acute asthma red flags — GPhC CRA MCQ
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Correct answer: D — Call 999 and give repeated reliever doses through a spacer
Call 999 and give repeated reliever doses through a spacer: Inability to speak in sentences and poor reliever response indicate a severe or life-threatening attack requiring emergency transfer and immediate bronchodilator support. Supply one salbutamol inhaler and arrange GP review the following day: A retail supply does not address current severe respiratory compromise. Arrange a routine same-day appointment and observe the patient untreated: Emergency escalation and immediate supportive treatment should not be delayed. Give a sedating antihistamine and reassess respiratory status after 30 minutes: Sedation is hazardous and does not treat acute bronchospasm. Move the patient outdoors and reassess before arranging ambulance transfer: Exertion and delayed escalation may worsen a severe attack.
Reference: BTS/NICE/SIGN asthma pathway: management of acute asthma in adults: https://www.rightdecisions.scot.nhs.uk/asthma-pathway-bts-nice-sign-sign-244/managing-acute-asthma/management-of-acute-asthma-in-adults/acute-asthma-in-adults/; BNF: salbutamol: https://bnf.nice.org.uk/drugs/salbutamol/