Feature Article

Worsening asthma in adults. Part 2: Assessment and management of asthma exacerbations

Feature Article

Worsening asthma in adults. Part 2: Assessment and management of asthma exacerbations

Paul J Hamor, Kwok Yan, Helen Reddel

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Abstract

This second part of a two-part article discusses the assessment and management of patients who present to their GP with an asthma exacerbation. Moderate exacerbations can be managed in the community but urgent hospital transfer is required if the exacerbation is severe or the patient has high-risk features or deteriorates despite treatment.

Key Points

  • Undertake triage and risk-stratification of patients presenting in primary care with an asthma exacerbation to determine therapeutic management.
  • Identify patients who are high risk or have acute severe asthma early and transfer to hospital.
  • Inhaled bronchodilators and corticosteroids are the cornerstone of therapy.
  • Assess patient response to therapy regularly and frequently (e.g. monitor every 15 minutes for the first hour and re-evaluate after one hour).
  • Transfer patients to hospital if there is no response to treatment or deterioration despite treatment.
  • Before discharging patients home after management in general practice, ensure they have a written asthma action plan, good inhaler technique and a review appointment organised.