Acute asthma

Managing acute asthma in adults

If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination.

Assess response to treatment using spirometry, oxygen saturation, heart rate, respiratory rate and pulsus paradoxus status. 

Wheeze is an unreliable indicator of the severity of an asthma attack and may be absent in severe asthma. 

Ensure every patient receives adequate follow-up after an acute asthma episode, including review of medications, triggers and asthma action plan. 

Managing acute asthma in children

If the patient is acutely distressed, give oxygen and SABA immediately after taking a brief history and physical examination. 

Emergency management of acute asthma in a child is based on initial administration of salbutamol 4-6 puffs (< 6 years) or 8-12 puffs (≥6 years) via MDI.

Load the spacer with one puff at a time and give each puff separately.

If treatment with an oral corticosteroid (e.g. prednisolone 1 mg/kg up to 60 mg as a single daily dose) has been initiated for a moderate-to-severe acute episode, continue for up to 5 days.