CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Asthma - Management
What assessment is recommended during an exacerbation of asthma?
- Ask about possible trigger factors, such as a recent upper respiratory tract infection.
- Ask about the type and duration of symptoms, what treatment has been started (if any), and whether treatment has improved symptoms.
- Assess the severity of the exacerbation:
- Look for signs of exhaustion (inability to complete sentences) and cyanosis (bluish lips or extremities).
- Examine the person's chest and record the respiratory rate, pulse, and blood pressure.
- Record the peak expiratory flow rate (if the person is old enough to comply) and use the best of three recordings to grade the severity of the attack on the basis of the person's best or predicted value:
- Moderate: more than 50–75%.
- Acute severe: 33–50%.
- Life-threatening: < 33%.
- Measure a person's oxygen saturation in room air using pulse oximetry (if available).
- Ask about depression, alcohol misuse, poor compliance with medication, social isolation and previous exacerbations as these factors will reduce the threshold for hospital admission.
In depth
© NHS Institute for Innovation and Improvement