Asthma Has 12 Hours in Medicine / Internal Medicine — 17yo Child | Respiratory / Pulmonology | SMLE Q#12449
SMLE Question #12449
Medicine / Internal Medicine
Respiratory / Pulmonology
Objective: OBJ-123
Last updated: February 2026
A 17-year-old boy with asthma has 12 hours of worsening dyspnea despite frequent inhaled salbutamol and his maintenance inhaled corticosteroid. Two years ago, he required intubation for status asthmaticus. In the ED, he has marked respiratory distress, speaks in short phrases, and has diffuse expiratory wheeze. After 1 hour of repeated nebulized short-acting β2-agonist and systemic corticosteroid, he remains in significant distress with persistent wheeze. Chest radiograph shows hyperinflation without infiltrate or pneumothorax. What is the most appropriate next step in management?
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