Ashtekar 2008.

Methods	Parallel 1 Children’s Assessment Unit, 1 hospital (UHW).
Participants	Inclusion criteria: age range 2 to 16 years, acute severe asthma. Exclusion criteria: chronic lung disease, congenital heart disease, unable to understand English. 17 randomised (8 boys). Intervention: 7 completed. Control: 10 completed.
Interventions	Intervention: 2.5 mL isotonic MgSO₄ (3 occasions at 20‐minute intervals), salbutamol and ipratropium bromide. Control: 2.5 mL isotonic saline (3 occasions at 20‐minute intervals), salbutamol and ipratropium bromide. 3 dosages over 1 h: follow‐up for 240 minutes.
Outcomes	Asthma severity scores (ASS), the sum of wheeze, accessory muscle use and heart rate, were computed on 6 occasions over 4 h. The primary endpoint was the area under the curve of the ASS at the 6 time points for each child.
Notes	Funding: local R and D pilot funding.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Block randomisation by pharmacy at source ‒ in ED as sequential vials (code in pharmacy).
Allocation concealment (selection bias)	Low risk	As above – absolute concealment.
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Trial described as double blind: as above.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Trial described as double blind: as above.
Incomplete outcome data (attrition bias) All outcomes	Low risk	All data collected for the 17 patients.
Selective reporting (reporting bias)	Unclear risk	Abstract only. Outcomes partially reported.