A 28-year-old patient presents to the emergency department with wheezing, shortness of breath, and chest tightness. After initial assessment, you administer a short-acting beta-2 agonist via nebulizer. The patient's symptoms improve, but not completely. What is the most appropriate next step in management?
The correct answer is to administer systemic corticosteroids. In acute asthma exacerbations, systemic corticosteroids are a crucial component of treatment. They help reduce airway inflammation, decrease mucus production, and enhance the effectiveness of beta-2 agonists. Corticosteroids should be given early in the course of treatment, usually within the first hour of presentation, to all patients with acute asthma exacerbations except those with very mild symptoms.
While continuous nebulized beta-2 agonists can be beneficial, they are typically used in conjunction with corticosteroids rather than as a sole next step. Intubation is reserved for severe cases unresponsive to other treatments and would be premature at this stage. Administering IV magnesium sulfate, while sometimes used in severe asthma exacerbations, is not the most appropriate next step for a patient showing partial improvement with initial treatment.
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