A 34-year-old woman with asthma remains breathless in the emergency department after three nebulised doses of salbutamol and ipratropium and intravenous hydrocortisone. She speaks in short phrases, has a respiratory rate of Thirty-two per minute and a peak expiratory flow rate of 32% of her predicted value. Chest examination reveals widespread polyphonic wheeze with poor air entry. Which one of the following is the most appropriate next treatment?
Keep going — a set of ten like this one, one at a time.
Practise moreMore from Respiratory
See allA 71-year-old man with severe chronic obstructive pulmonary disease presents with three days of increasing breathlessness and green sputum. On arrival he is dro…
Pre-internship · middle twist
A 58-year-old man was started on oral amoxicillin five days ago for right lower lobe pneumonia. He returns because his fevers have continued and he is more brea…
Pre-internship · middle twist
A 26-year-old woman with asthma is reviewed after three hours of emergency department treatment with inhaled salbutamol and ipratropium, systemic corticosteroid…
Pre-internship · middle twist
A 24-year-old woman with asthma remains breathless after repeated nebulised salbutamol and ipratropium, intravenous hydrocortisone and oxygen. She can speak onl…
Clinical rotations · common
A 54-year-old man presents with five days of fever, dry cough, headache and diarrhoea after returning from a Mediterranean cruise. He is confused, respiratory r…
Clinical rotations · middle twist