A patient with acute sever asthma exacerbation should not be treated with ICS, he should be admitted to the hospital and treated with oral or parenteral corticosteroids.

Children with signs of a life-threatening exacerbation (e.g., drowsiness, confusion, silent chest) are admitted to the paediatric intensive care unit for treatment and respiratory support (e.g., high-flow humidified nasal cannulae, non-invasive ventilation, or intubation and mechanical ventilation).

(GINA 2023)