Soru

A 9-year-old boy is brought to the emergency department via ambulance for severe difficulty breathing. His parents report that his symptoms began $12$ hours ago with a cough and wheezing, and worsened significantly over the past $6$ hours. He has a history of moderate persistent asthma and has been using his albuterol inhaler every hour for the past $6$ hours without relief. He is fully immunized. On arrival, the patient is agitated, diaphoretic, and speaking in single words. His temperature is $37.1^\circ\text{C}$ ($98.8^\circ\text{F}$), blood pressure is $110/70\text{ mm Hg}$, pulse is $148/\text{min}$, and respirations are $44/\text{min}$. Pulse oximetry shows $86\%$ on room air. Physical examination reveals marked suprasternal and subcostal retractions. Lung auscultation reveals diminished air entry bilaterally with a prolonged expiratory phase and faint, high-pitched expiratory wheezing. Arrange the following interventions in the most appropriate sequence of administration for this patient's acute management.