ii. Group #2: This group will receive all standard of care therapies as per the pediatric ED Asthma Severity Protocol. All nebulized treatments will be given via the NIPPV/BiPAP machine via the Servo i Ventilator. The treating PED Attending and treating PED respiratory therapist will be blinded to the BiPAP/NIPPV settings during the study period. The PED clinical trial research assistant and in conjunction with one of the study investigators will adjust the BiPAP settings in concert with the treating physician. The discussion will be about either increasing or decreasing the IPAP or EPAP not the true number changes to keep it blinded, will be as follows: The inspiratory positive airway pressure (IPAP) will be started at 10 cm H2O for all patients. The patient will be observed clinically by a PED respiratory therapist in conjunction with the treating pediatric ED attending and/or fellow. The IPAP will be increased as needed by 2 cm H2O up to a maximum IPAP of 16 cm H2O for patients 2-6 years of age, 20 cm H2O for patients 7-12 years of age, and 24 cm H2O for patients older than 12 years. The expiratory positive airway pressure (EPAP) will be set at 5 cm H2O. If the IPAP settings are maximized based on age and the respiratory distress score continues to be 5 or greater, the EPAP can be increased by 1 cm H2O to a maximum of 8 cm H2O for all patients less than 12 years and 10 cm H2O for all patients older than 12 years. The I:E setting will be 1.75 seconds. Optimal settings for each participant should be achieved within 20 minutes of initiation of BiPAP and respiratory distress scores should recorded at least every 5 minutes or with every BiPAP settings change during this period. Pediatric asthma scores will continue to be recorded at least every 30 minutes or with every physician suggested NIPPV ventilator setting change for an 8 hour period. Furthermore, the NIPPV ventilator, Servo i ventilator, has volumetric end tidal CO2 monitoring capabilities and will record ventilatory data in this NIPPV/BiPAP group and will be compared to other study groups.