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Life-threatening asthma — RCPSC EM MCQ

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HardRespiratory emergenciesLife-threatening asthmaRCPSC EM

A 24-year-old woman with asthma arrives CTAS 1 after repeated salbutamol at home. She is exhausted, RR is 8, SpO2 is 88% on high-flow oxygen, and there is minimal wheeze. ABG shows pH 7.18 and PaCO2 62 mmHg. What is the most appropriate next step?

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Correct answer: B — Prepare controlled intubation while continuing bronchodilators

Silent chest, hypercapnia, exhaustion and hypoxaemia indicate impending respiratory arrest in asthma. Intubation is high-risk and should be planned while medical therapy continues.

Reference: ACLS/ATLS/PALS principles adapted to Canadian ED practice