Which treatment is indicated for severe acute asthma in an emergency room setting?

In an emergency room setting for severe acute asthma, intravenous (IV) steroids are indicated because they have the advantage of rapid onset and can effectively reduce inflammation in a critical situation. Patients experiencing severe asthma exacerbations may have significant airway inflammation, and IV steroids deliver a potent anti-inflammatory effect quickly, crucial for managing acute symptoms and preventing further complications.

While inhaled steroids are beneficial for long-term management of asthma, they take time to exert their full effect and are not appropriate in acute situations due to their delayed action. Oral steroids can be useful but may not act as rapidly as IV formulations, which is particularly important when a patient is in urgent distress. Beta-agonists, such as albuterol, are essential for immediate bronchodilation and often administered as nebulizers or metered-dose inhalers; however, they do not address the underlying inflammation that IV steroids do. In severe cases, a combination of treatments may be used, but the urgency surrounding inflammation control underscores why IV steroids are crucial in emergency interventions for severe acute asthma attacks.