A 3–year-old boy is brought to the casualty by his mother with progressive shortness of breath for 1 day. The child has a history of bronchial asthma. On examination, the child is blue, gasping and unresponsive What will you like to do first –

The symptoms given by the child shows that he is suffering from life-threatening asthma. Presence of any of the following indicates life-threatening Asthma. a) Cyanosis                 b) Silent chest                       c) Poor respiratory effects d) Altered sensorium e) Exhaustion, fatigue        f) PEFR < 30 % of predicted and O2 saturation of < 90 % Management of life-threatening asthma (status asthmaticus) Immediate O2 inhalation Injection of terbutaline or adrenaline (s.c.) Inhalation of salbutamol or terbutaline and ipratropium Injection of hydrocortisone 10mg/kg. After the above-mentioned steps, an arrangement is made to transfer the patient to ICU.