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Management of acute asthma. Lessons learnt from studies of asthma deaths. Many deaths from asthma are preventable – 88-92% of attacks requiring hospitalisation develop over  6 hours Factors include: inadequate objective monitoring failure to refer earlier for specialist advice

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Management ofacute asthma


Lessons learnt fromstudies of asthma deaths

  • Many deaths from asthma are preventable – 88-92% of attacks requiring

  • hospitalisation develop over 6 hours

  • Factors include:

  • inadequate objective monitoring

  • failure to refer earlier for specialist advice

  • inadequate treatment with steroids


Levels of severity ofacute asthma exacerbations




Management of acute severe asthma assessment of PEFin adults in A&E: PEF 33-75% predicted


Management of acute severe asthma assessment of PEFin adults in A&E: PEF 33-75% predicted


Management of acute severe asthma assessment of PEFin adults in A&E: PEF 33-75% predicted



Management of acute severe predictedasthma in adults in hospital

Caution: Patients with severe attacks may not be distressed and may not have all these abnormalities. The presence of any should alert the doctor.


Management of acute severe predictedasthma in adults in hospital

Caution: Patients with life threatening attacks may not be distressed and may not have all these abnormalities. The presence of any should alert the doctor.


Management of acute severe predictedasthma in adults in hospital


Management of acute severe predictedasthma in adults in hospital


Management of acute severe predictedasthma in adults in hospital


Management of acute severe predictedasthma in adults in hospital


Management of acute severe predictedasthma in adults in hospital


Oxygen treatment for predictedacute asthma in adults


ß predicted2-agonist bronchodilatorsfor acute asthma in adults


Steroids predicted and other therapyfor acute asthma in adults


Monitoring of adults with predictedacute asthma


Hospital discharge and predictedfollow up after acute asthma

  • GP review within 48 hours

  • Monitor symptoms and PEF

  • Check inhaler technique

  • Written asthma action plan

  • Modify treatment according to guidelines for chronic persistent asthma

  • Address factors that could have contributed to admission


Overview: Management predictedof acute asthma

  • Assess and act promptly in acute asthma

  • Admit patients with any feature of a life threatening or near fatal attack, or severe attack persisting after initial treatment

  • Measure oxygen saturation

  • Use steroid tablets

  • Primary care follow up required promptly after acute asthma

Management of acute asthma. Thorax 2003; 58 (Suppl I): i1-i92


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