Severe asthma drug — DipIMC MCQ
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Correct answer: B — Nebulised salbutamol 5 mg with ipratropium 500 micrograms
Explanation lettering: B = shown as A · E = shown as B · D = shown as C · A = shown as D · C = shown as E
E is correct: Severe acute asthma is treated with oxygen-driven beta-agonist nebulisation and anticholinergic bronchodilator. A is less suitable because a large initial opioid bolus risks hypotension and respiratory depression; B is less suitable because the dose is below standard severe adult asthma nebuliser dosing; C is less suitable because cardiac-arrest adrenaline dosing is inappropriate in a perfusing patient; D is less suitable because analgesia is important but does not replace the first physiological intervention. The most tempting alternative is therefore suboptimal because it either delays the time-critical pre-hospital intervention or sends the patient to the wrong level of care. The key DipIMC principle is focused cABCDE decision-making with early pre-alert, triage or retrieval escalation when the scene physiology demands it.
Reference: JRCALC Guidelines; Resuscitation Council UK; NICE guidance where applicable