A child came to the ED with severe asthma and not responding to
salbutamol nebulizer and vomiting many times. What is the most
appropriate management?
a. Salmetrol
b. Montelukast
c. Prednisolone
d. Budesonide inhaler
e. Oxygen
f. IV salbutamol
answer: E
The case tells us this is 'severe asthma' and not responding to nebulized salbutamol, this indicates 0
2 saturation is below 90%.
Next step will be oxygen.
Vomiting is an important piece of information here because it is caused by the power of the diaphram when the patient is having coughing fits. This indicates sufficient respiratory effort is present to delay IV salbutamol.
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