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Life-threatening asthma — RCPSC EM MCQ

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HardRespiratory emergenciesLife-threatening asthmaRCPSC EM

A 23-year-old with asthma is exhausted after repeated salbutamol. RR 10, SpO2 90% on oxygen, silent chest, pH 7.18, PaCO2 64 mmHg, and he is unable to speak. What is the most appropriate next step?

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

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Correct answer: D — Call for expert airway support and prepare for controlled intubation while continuing bronchodilators and steroids

Exhaustion, silent chest and rising CO2 indicate impending respiratory arrest; airway preparation and maximal asthma therapy are needed.

Reference: Canadian Thoracic Society asthma guidance; airway management principles