In ER care for acute asthma, which therapy is commonly initiated first?

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Acute asthma care centers on quickly reversing bronchoconstriction to restore airflow. The fastest-acting therapy is an inhaled short-acting beta-agonist, delivered by nebulizer or inhaler with a spacer, because it directly relaxes airway smooth muscle via beta-2 receptors. This rapid bronchodilation open ups the airways, improves expiratory flow, and often reduces the patient’s work of breathing within minutes. In more severe cases, continuous inhaled SABA may be used to maintain ongoing bronchodilation. The other options don’t address the immediate problem of bronchospasm: antibiotics target infection and aren’t routinely used for isolated asthma attacks; oral antihistamines don’t relieve acute bronchoconstriction; anticoagulation isn’t indicated for asthma management. Systemic corticosteroids are important too, but they don’t provide the instant relief that a bronchodilator offers.