Question 1

You are on the acute medical ward round seeing a 21-year-old patient named Tim.

Tim was admitted to hospital last night with a flare-up of ulcerative colitis. This morning, he feels breathless. He informs you that he is asthmatic, and has a "blue inhaler" at home which has not been prescribed.

It is clear that Tim is working hard to breathe. He is struggling to finish his sentences. His pyjamas are damp with sweat. One of the healthcare assistants informs you that Tim’s respiratory rate is thirty-one breaths per minute.

You sit Tim upright and start oxygen. Your consultant asks for an ABG, so that you can assess the severity of the asthma attack and inform the critical care team if necessary:

How severe is Tim’s asthma attack?