This study is a prospective and randomized clinical trial to investigate the utility of BiPAP therapy for the pediatric patient in an acute moderate to severe asthma exacerbation. The study will be conducted in the pediatric emergency department at Arkansas Children's Hospital. Patients between 2-17 years old will be identified to participate based on the past medical history, history of present illness and PAS and the consent process will begin immediately. All patients will be started on standard of care therapies including continuous albuterol and atrovent aerosols, intravenous corticosteroids, intravenous magnesium sulfate and a normal saline fluid bolus. Additional therapies with subcutaneous epinephrine or terbutaline will be given at the discretion of the treating physician in the first 20 minutes. Further escalation of asthma therapy, for example administration of IV bronchodilators, ketamine, terbutaline and/or epinephrine will be at the discretion of the treating physician. The history of present illness, past medical history, triage information and initial physical exam information will be collected by the study investigator in the first hour and marked on the data sheet.