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Severe acute asthma — RACP Paediatrics MCQ

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HardRespiratorySevere acute asthmaRACP Paediatrics

A 10-year-old with asthma has persistent severe work of breathing after back-to-back inhaled salbutamol and ipratropium. Oxygen saturation is 91% on oxygen, pulse is 150/min and he can speak single words. Chest is quiet at the bases. What is the most appropriate management?

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Correct answer: B — Give intravenous magnesium sulfate and involve intensive care early

The quiet chest, hypoxia and inability to speak normally indicate life-threatening asthma despite initial inhaled therapy. Intravenous magnesium and early intensive care involvement are appropriate while continuing oxygen and bronchodilator therapy. A quiet chest is a danger sign, not a reason to stop treatment.

Reference: RCH Acute asthma guideline; Therapeutic Guidelines (eTG)