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Acute severe asthma — DCH MCQ

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HardPaediatric emergenciesAcute severe asthmaDCH

A 12-year-old boy with asthma is brought to ED. He is unable to complete sentences, respiratory rate 34/min, pulse 132/min, oxygen saturation 91% in air, and peak flow is 38% predicted. What is the most likely diagnosis?

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Correct answer: A — Acute severe asthma

Low oxygen saturation, inability to complete sentences and peak flow below 50% predicted indicate acute severe asthma. Panic can cause dyspnoea, but the hypoxia, wheeze history and reduced peak flow support asthma severity. The pearl is that objective peak flow helps grade severity when the child can perform it.

Reference: BTS/SIGN Asthma; NICE NG245; BNFc