A 25-year-old woman with known asthma presents with an acute worsening of her symptoms. She is short of breath, wheezing, and her reliever inhaler is not helping. Her pulse oximetry reading is 90%. What is the likely diagnosis and next steps?
This patient's symptoms suggest that she is experiencing an acute asthma exacerbation, often referred to as an asthma attack. When a patient with known asthma presents with worsening symptoms unresponsive to their usual rescue medication, this is a medical emergency. The immediate next steps would involve administering high-flow oxygen to improve her oxygen saturation, repeated administration of a rapid-acting bronchodilator (like albuterol) through a nebulizer, and likely systemic corticosteroids to reduce inflammation in the airways.