5th January 2024

A 21-year-old patient is admitted to A&E with acute exacerbation of asthma

A 21-year-old patient is admitted to A&E with acute exacerbation of asthma. On examination, he looks tired, has a wheezy chest, and cannot complete full sentences. His ABG shows PH 7.45, PaO2 10, PaCO2 2.8, HCO2 27. He is started on 100% oxygen, IV steroids IV magnesium and salbutamol nebuliser. His repeat ABG 1 hour later shows PH of 7.3 PaO2 14.8 PaCO2 5. What is the most appropriate next step?

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