History

The following information should be obtained as soon as possible after the patient presents with acute asthma:

• the cause of the present exacerbation (e.g. upper respiratory tract infection, allergen exposure, food allergy)
• the duration of symptoms (with increasing duration of the attack, exhaustion and muscle fatigue may precipitate ventilatory failure)
• the severity of symptoms, including exercise limitation and sleep disturbance
• details of all current asthma medications, doses and amounts used, including the time of the last dose. (Distinguish between preventer medications and reliever medications used for the acute attack)
• medication adherence history
• details of other medications. (Check whether the person has used any medications that might aggravate asthma, including complementary/herbal medications.)
• prior hospitalisations and Emergency Department visits for asthma or anaphylaxis, particularly within the last year
• exposure to nonsteroidal anti-inflammatory drugs or aspirin
• prior episodes of severe life-threatening asthma (e.g. admissions to intensive care unit, ventilation)
• significant coexisting cardiopulmonary disease
• the presence of underlying chronic obstructive pulmonary disease (indicates risk of CO₂ retention)
• known immediate hypersensitivity to food, bee sting or drugs
• smoking history. 

Content Created (Thursday, 16 November 2006)