Algorithm for the management of acute asthma Oxygen Supplemental oxygen must be administered whenever possible in patients with moderate to severe acute asthma. Also, nebulised bronchodilators should whenever possible be delivered by oxygen-driven nebulisers. Most patients with moderate to severe acute asthma have hypoxia that is readily corrected by supplemental oxygen.How to administer? Oxygen is generally administered by facemask and response monitored with pulse oximetry to maintain an O2 saturation over 92% .Lack of pulse oximetry should not prevent oxygen being administered. There is usually no need to administer more than 40% oxygen. The flow rates are determined by the recommendations on the specific facemasks. If inhaled bronchodilator therapy is given by nebulisers, they should preferably be driven by oxygen at a flow rate of at least 6 l/min to prevent hypoxaemiaIntravenous fluids are administered in acute severe asthma based on the clinical setting, taking into account maintenance and replacement requirements and the need for calorie intake in patients unable to take oral fluids. There are no formal studies of routine fluid administration in acute asthma.