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Severe asthma attack — GPhC CRA MCQ

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HardRespiratory TherapeuticsSevere asthma attackGPhC CRA

A 19-year-old man with asthma asks to buy cough medicine but is too breathless to complete sentences. His salbutamol inhaler gives relief for only a few minutes. His PEFR is 45% of personal best and pulse is 124bpm. What is the most appropriate action?

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Correct answer: A — arrange emergency transfer and give repeated salbutamol via spacer while awaiting help

Breathlessness limiting speech, tachycardia and PEFR below 50% personal best indicate a severe asthma attack. Emergency care is required and high-dose inhaled salbutamol via spacer should be given while awaiting help. Starting routine preventer treatment alone is inadequate during an acute severe attack. Cough suppressants and steam inhalation do not address bronchospasm.

Reference: BNF; NICE CKS: Asthma