<prompt> A 13-year-old known asthmatic presents with severe wheezing and a respiratory rate of 40. Her pulse rate is 120. What is the next best step in management of this patient?Oxygen and nebulised salbutamolOxygen and Metered dose inhaler of salmeterolOxygen and intravenous AminophyllineOxygen and Intravenous magnesium sulphate  <response>: For severe acute asthma Oxygen Nebulized salbutamol is recommended Other option- Oxygen and metered dose inhale of salmeterol - for prevention of asthma Oxygen and Intravenous aminophylline - cause toxicity Oxygen IV Magnesium sulphate - not recommended now days 