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Acute severe asthma — DIPIMC MCQ

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ModerateMedical EmergenciesAcute severe asthmaDIPIMCDipIMC

A known asthmatic is breathless with a peak flow of 40 percent of best, a respiratory rate of 28 and an inability to complete sentences. Oxygen saturations are 93 percent.

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

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Correct answer: A — Give high-flow oxygen, nebulised salbutamol and ipratropium, and systemic steroids.

Acute severe asthma is treated with oxygen titrated to high-normal saturations, nebulised salbutamol and ipratropium, and systemic corticosteroids. Salbutamol alone with early discharge is inadequate for an acute severe attack. The 88 to 92 percent oxygen target applies to those at risk of hypercapnic respiratory failure, not to an acutely hypoxic asthmatic.

Reference: BTS/SIGN Asthma Guideline