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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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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
Initial assessment – the role of symptoms, signs and measurements
Management of acute severe asthma in adults in A&E: assessment of PEF
Management of acute severe asthmain adults in A&E: PEF 33-75% predicted
Management of acute severe asthmain adults in A&E: PEF 33-75% predicted
Management of acute severe asthmain adults in A&E: PEF 33-75% predicted
Management of acute severe asthma in adults in A&E: PEF <33% predicted
Management of acute severeasthma 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 severeasthma 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.
Hospital discharge andfollow 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: Managementof 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