You are the tertiary ED consultant on duty. Your team is treating a 40-year-old male with severe life-threatening asthma. The patient is currently alert, GCS 15, RR 32, saturating 88% on 15L/min O2, BP 150/95. You have optimised medical therapy.

1. State the benefits of NIV in this setting. (2 marks) 2 marks

After 1 hour, despite maximal therapy and NIV, your patient starts to fatigue. You have decided to intubate the patient.

2. Post-intubation, outline (4) of your ventilator settings and explain the rationale for each of your choices. (8 marks) 8 marks

15 minutes post-intubation, the patient becomes hypotensive 72/50.

3. What are (4) potential aetiologies and what steps would you take to treat them? (8 marks) 8 marks