A 5-year-old male with a history of asthma presents to a small community hospital ED with three days of worsening shortness of breath that requires transfer to a pediatric capable facility. Learners must recognize severe asthma and initiate usual asthma treatment, but the child does not respond to these basic treatments and continues to worsen. The patient continues to tire and requires intubation. If not treated aggressively, the patient will become hypotensive and increasingly hypoxic, potentially leading to arrest.

Learning Objectives

– Displays leadership by maintaining a calm demeanor and acting decisively

– Communicates effectively by using a closed loop, listening to the input of others, and addressing concerned family members

– Implements basic ED treatment of asthma – Recognizes refractory/severe asthma and institutes appropriate treatments

– Recognizes the need for and demonstrates an ability to intubate the patient