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Asthma - Management
How should I manage children with an intermediate probability of asthma who can perform airway obstruction tests?
- Check for airway obstruction using spirometry:
- Spirometry should be done by a trained healthcare professional; if this is not possible, seek advice.
- If there is no evidence of airway obstruction, consider referring to secondary care for additional tests.
- If there is evidence of airway obstruction, assess for reversibility to either bronchodilator therapy (e.g. salbutamol 400 micrograms via metered-dose inhaler and spacer) and/or to a trial of asthma treatment for 2–3 months:
- If there is significant reversibility (greater than 12% increase in forced expiratory volume in 1 second [FEV1]) or clinical response to a trial of asthma treatment is good, a diagnosis of asthma is probable. Continue to treat as asthma.
- If there is no significant reversibility (less than 12% increase in FEV1), and a trial of treatment is not beneficial, refer to secondary care for additional tests.
- If it is unclear whether a child has improved on a trial of asthma treatment, careful observation during a trial of treatment withdrawal may clarify whether they have responded to asthma treatment.
In depth
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