17th February 2025

A 19-year-old lady presents to A&E with chest tightness, wheeze and difficulty in breathing.

A 19-year-old lady presents to A&E with chest tightness, wheeze and difficulty in breathing. She has a background of asthma, for which she takes a salbutamol inhaler and a steroid inhaler. 

On arrival, her observations are: HR 101 bpm, BP 120/66 mmHg, temperature 36.2 degrees Celsius, RR 24 /minute, sats 92% on room air.

She is given salbutamol and ipratropium inhalers and 40 mg of prednisolone. On assessment, she seems slightly tired and disoriented.

An ABG on 4L oxygen shows the following: pH 7.39, pO2 10.1, pCO2 5.5, bicarbonate 20

What is the most appropriate next action?

Select the SINGLE most appropriate option from the list below. Select ONE option only.