Case Study:
A 14-year-old girl with a history of asthma requiring daily inhaled corticosteroid therapy and allergies to house dust mites, cats, grasses, and ragweed presents to the emergency department in mid-September, reporting a recent “cold” complicated by worsening shortness of breath and audible inspiratory and expiratory wheezing. She appears frightened and refuses to lie down but is not cyanotic. Her pulse is 120 bpm, and respirations are 32/min. Her mother states that she has used her albuterol inhaler several times a day for the past 3 days and twice during the previous night. She took an additional two puffs on her way to the emergency department, but her mother states that “the inhaler didn’t seem to be helping so I told her not to take any more.”
Questions:
What emergency measures are indicated?
How should her long-term management be altered?