A 17-year-old with asthma arrives as triage level 1 after using repeated albuterol at home. He is silent on auscultation, RR 10/min, oxygen

Question

A 17-year-old with asthma arrives as triage level 1 after using repeated albuterol at home. He is silent on auscultation, RR 10/min, oxygen saturation 90%, pH 7.18, PaCO2 68 mm Hg, and he appears exhausted. Which of the following is the most important immediate intervention?

Accepted Answer

Rapid sequence intubation with continued bronchodilators and ventilator strategy allowing prolonged expiration

Answer

Administer oral antibiotics as primary therapy

Answer

Give IV beta-blocker for tachycardia

Answer

Discharge after one additional nebulizer

Answer

Delay airway management until chest radiograph results

Life-threatening asthma — ABEM Board MCQ

A 17-year-old with asthma arrives as triage level 1 after using repeated albuterol at home. He is silent on auscultation, RR 10/min, oxygen saturation 90%, pH 7.18, PaCO2 68 mm Hg, and he appears exhausted. Which of the following is the most important immediate intervention?