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Status epilepticus — DipIMC MCQ

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HardMedical EmergenciesStatus epilepticusDipIMC

A 45-year-old with asthma is unable to complete sentences, has RR 34/min, pulse 128/min and SpO2 90% on air. There is widespread wheeze but no urticaria or hypotension. Which immediate treatment bundle is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Provide oxygen, nebulised salbutamol, corticosteroid and emergency transfer

The best answer is “Provide oxygen, nebulised salbutamol, corticosteroid and emergency transfer”. This is acute severe asthma with hypoxaemia and inability to speak. Give oxygen-driven short-acting beta2-agonist treatment, systemic corticosteroid early and arrange senior escalation; ipratropium is an important add-on in severe attacks. IM adrenaline is reserved for anaphylaxis or specific life-threatening circumstances, while sedatives and oral bronchodilators risk deterioration or delay effective treatment.

Reference: BTS/SIGN British guideline on the management of asthma (SIGN 158): https://www.brit-thoracic.org.uk/document-library/guidelines/asthma/btssign-guideline-for-the-management-of-asthma-2019-sign-158/