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Life-threatening asthma — RCPSC EM MCQ

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HardRespiratory emergenciesLife-threatening asthmaRCPSC EM

A 22-year-old with asthma is exhausted after continuous salbutamol and ipratropium. RR falls from 38 to 18/min, she speaks one word at a time, and oxygen saturation is 90% on high-flow oxygen. ABG shows pH 7.19, PaCO2 62 mmHg, and PaO2 68 mmHg. What is the most appropriate next step?

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

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Correct answer: DCall for expert airway support and prepare controlled intubation while continuing maximal therapy

Call for expert airway support and prepare controlled intubation while continuing maximal therapy is correct: the clues indicate Life-threatening asthma and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: Canadian asthma emergency practice; critical care airway principles