emergency department in status asthmaticus. His dad
reports he had just been picked for the school soccer team
and was playing his first game when he started to wheeze,
but didn’t want to come off and use his prescribed inhalers.
Dad reports this has been the case more and more as
Simon has moved in to his teenage years. On examination,
Simon has an audible wheeze and is unable to speak in full
sentences. His respiratory rate is 32 breaths per minute.
Pulse oximetry reveals an SaO2 of 88% and a pulse rate of
132. He appears a little cyanotic and is visibly distressed
and anxious. When asked what medication he was taking,
Dad says that Simon had just been taking his “normal
puffers”, but Simon says that he had also been taking
ibuprofen for a sprained ankle he picked up in training.