Asthma Overview and History Quiz
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Questions and Answers

Which medication is recommended for managing asthma by controlling inflammation?

  • Theophyllines
  • Long acting B2 agonists
  • Inhaled steroids (correct)
  • Leukotriene receptor antagonists

    • What should be considered as triggers in asthma management?

  • Diet and nutrition
  • Family history of asthma
  • Allergies and occupation (correct)
  • Previous hospital admissions

    • What is a key characteristic of COPD?

  • History of asthma in childhood
  • Reversible airway obstruction
  • Irreversible airways disease (correct)
  • Only affects smokers

    • How can peak flow measurements assist in asthma management?

    <p>Monitoring asthma control and severity</p> Signup and view all the answers

    Which of the following statements about nebulisers is correct?

    <p>Salbutamol is commonly used in nebulisers.</p> Signup and view all the answers

    What does the anti-IgE medication, omalizumab, primarily target?

    <p>IgE-mediated allergic reactions</p> Signup and view all the answers

    What is the recommended approach to assess COPD severity?

    <p>Assessment of productive cough duration</p> Signup and view all the answers

    What does bronchial thermoplasty aim to improve in asthma management?

    <p>Decrease smooth muscle mass</p> Signup and view all the answers

    Which of the following symptoms is typically associated with asthma?

    <p>Nocturnal cough</p> Signup and view all the answers

    What is a key diagnostic clue indicating COPD?

    <p>Slowly progressive symptoms</p> Signup and view all the answers

    Which of the following is NOT a common trigger for asthma symptoms?

    <p>Swollen leg</p> Signup and view all the answers

    What is a common risk factor for pulmonary embolism (PE)?

    <p>Obesity and immobility</p> Signup and view all the answers

    Which statement regarding lung cancer is true?

    <p>It is the third biggest cause of death.</p> Signup and view all the answers

    Which of the following findings is indicative of a pneumothorax?

    <p>Quiet breath sounds</p> Signup and view all the answers

    Which condition is most likely characterized by inspiratory wheeze?

    <p>Asthma</p> Signup and view all the answers

    What is the economic burden of asthma on the NHS?

    <p>£3 billion</p> Signup and view all the answers

    What is the primary goal of using a Peak Flow diary in asthma management?

    <p>To monitor asthma control</p> Signup and view all the answers

    Which of the following is NOT considered a common trigger for asthma exacerbations?

    <p>Exercise-induced hypertension</p> Signup and view all the answers

    In COPD management, which medication class is primarily used for immediate relief of symptoms?

    <p>Short-acting beta agonists (SABA)</p> Signup and view all the answers

    What diagnostic investigation is primarily used to evaluate suspected pulmonary embolism (PE)?

    <p>CT scan</p> Signup and view all the answers

    What is a characteristic clinical sign of lung cancer that differentiates it from other respiratory conditions?

    <p>Weight loss</p> Signup and view all the answers

    Which of these treatment strategies is recommended for patients with asthma as a preventer?

    <p>Inhaled corticosteroids</p> Signup and view all the answers

    How does smoking influence asthma management?

    <p>It can worsen symptoms and increase exacerbations</p> Signup and view all the answers

    Which of the following leisure activities is linked to occupational exposure as a potential asthma trigger?

    <p>Woodworking</p> Signup and view all the answers

    What respiratory investigation is used to assess blood gases and oxygenation status?

    <p>Arterial blood gas (ABG) analysis</p> Signup and view all the answers

    According to Ockham's razor, what principle should guide clinical diagnosis?

    <p>The simplest explanation is usually correct</p> Signup and view all the answers

    Which of the following respiratory conditions has the highest economic burden on the NHS?

    <p>Asthma</p> Signup and view all the answers

    Which symptom is not commonly associated with lower respiratory tract conditions?

    <p>Cyanosis of the lips</p> Signup and view all the answers

    What is a significant risk factor that contributes to higher mortality rates in respiratory diseases?

    <p>Low socioeconomic status</p> Signup and view all the answers

    Which of the following is a characteristic sign that may indicate heart failure rather than a respiratory condition?

    <p>Swollen ankles</p> Signup and view all the answers

    In evaluating potential pneumonia, which symptom is most commonly associated with this respiratory condition?

    <p>Fever and chills</p> Signup and view all the answers

    Which diagnostic clue might suggest the presence of a pulmonary embolism (PE)?

    <p>Swollen leg alongside risk factors</p> Signup and view all the answers

    Which general symptom is least likely to be a trigger for asthma exacerbations according to common clinical understanding?

    <p>Frequent hydration</p> Signup and view all the answers

    What is a primary physiological sign that differentiates asthma from chronic obstructive pulmonary disease (COPD)?

    <p>Peaked flow readings</p> Signup and view all the answers

    Which condition is suggested by dry cough and crackles along with occupational exposure?

    <p>Interstitial lung disease</p> Signup and view all the answers

    Which of the following statements best describes Ockham's razor?

    <p>The simplest explanation is often the most accurate.</p> Signup and view all the answers

    What is a key indication of asthma severity during physical examination?

    <p>Not speaking in full sentences</p> Signup and view all the answers

    Which of the following respiratory investigations is primarily used to diagnose asthma?

    <p>Spirometry</p> Signup and view all the answers

    What common respiratory sign is observed in asthma but may also indicate a serious condition if life-threatening?

    <p>Cyanosis</p> Signup and view all the answers

    Which risk factor is linked to an increase in asthma exacerbations?

    <p>Exposure to triggers</p> Signup and view all the answers

    What type of respiratory sound would most likely indicate an obstruction?

    <p>Wheezing</p> Signup and view all the answers

    Which component in respiratory investigations is used to evaluate chronic diseases like COPD and asthma?

    <p>Spirometry</p> Signup and view all the answers

    Which of the following treatments is primarily aimed at providing prolonged control of asthma symptoms?

    <p>Long Acting Beta Agonist (LABA)</p> Signup and view all the answers

    Which investigative method is used to analyze blood gas levels in patients with respiratory conditions?

    <p>Arterial Blood Gas (ABG) analysis</p> Signup and view all the answers

    What is a significant aspect of managing asthma exacerbations effectively?

    <p>Using inhaled steroids as the first-line treatment</p> Signup and view all the answers

    In the context of asthma medications, which combination is most effective as a maintenance treatment?

    <p>Inhaled corticosteroids combined with long-acting B2 agonists</p> Signup and view all the answers

    What does the peak expiratory flow rate (PEFR) monitoring help to indicate in asthma patients?

    <p>The potential severity of an asthma exacerbation</p> Signup and view all the answers

    What is a common misconception regarding the use of nebulisers in asthma management?

    <p>Nebulisers can replace the need for inhaled medications</p> Signup and view all the answers

    Which physiological mechanism primarily drives eosinophil-mediated asthma?

    <p>Activation of IgE antibodies against allergens</p> Signup and view all the answers

    In chronic obstructive pulmonary disease (COPD), what is the primary irreversible change that occurs within the lungs?

    <p>Progressive airway narrowing and obstruction</p> Signup and view all the answers

    What is a critical consideration when assessing triggers in asthma management?

    <p>Including occupational exposures in assessments</p> Signup and view all the answers

    In asthma management, which treatment is specifically designed for patients with IgE-driven disease?

    <p>Anti-IgE therapies like omalizumab</p> Signup and view all the answers

    Which of the following respiratory conditions is associated with a variable wheeze and nocturnal cough?

    <p>Asthma</p> Signup and view all the answers

    Which clinical symptom is indicative of a possible pneumothorax?

    <p>Pleuritic pain</p> Signup and view all the answers

    What characteristic feature distinguishes COPD from asthma during evaluation?

    <p>Gradual progression of symptoms</p> Signup and view all the answers

    Which sign is most likely associated with heart failure rather than a primary respiratory condition?

    <p>Swollen ankles</p> Signup and view all the answers

    Which factor is most likely to contribute to higher mortality rates in respiratory diseases within disadvantaged groups?

    <p>Higher exposure to air pollution</p> Signup and view all the answers

    Which respiratory investigation is primarily used to assess for infections, fibrosis, and cancer in the lungs?

    <p>Chest X-Ray (CXR)</p> Signup and view all the answers

    What characterizes asthma as opposed to chronic obstructive pulmonary disease (COPD)?

    <p>Hyper-responsive and reversible airway changes</p> Signup and view all the answers

    Which of the following factors may negatively impact a patient's asthma control?

    <p>Improper inhaler technique</p> Signup and view all the answers

    Which statement best describes Hickam's Dictum in the context of patient diagnosis?

    <p>A patient can have as many diseases as they wish.</p> Signup and view all the answers

    What type of respiratory sound is commonly associated with obstruction?

    <p>Stridor</p> Signup and view all the answers

    During an asthma exacerbation, which clinical sign typically indicates the severity of the condition?

    <p>Patient ability to speak in full sentences</p> Signup and view all the answers

    Which of the following is a key feature of chronic inflammation seen in asthma?

    <p>Mucus hypersecretion</p> Signup and view all the answers

    What does an elevated d-dimer level in bloodwork typically indicate?

    <p>Pulmonary embolism</p> Signup and view all the answers

    Which risk factor is most commonly linked to childhood asthma exacerbations?

    <p>Previous hospitalizations for respiratory issues</p> Signup and view all the answers

    Which condition is most likely indicated by the combination of pleurisy and a productive cough?

    <p>Pneumonia</p> Signup and view all the answers

    Study Notes

    Asthma

    • Common, atopic patient
    • Chronic inflammation of the airways
    • Hyper-responsive and reversible
    • Inflammatory cells infiltrate the airways
    • Smooth muscle hypertrophy
    • Thickening of the airway
    • Trigger by pollution, occupational exposure, allergens, bacteria and viruses, cold air

    Asthma History

    • Risk factors: smoking, family history, childhood infections, pollution, prematurity, occupation (chemicals, dusts, spores)
    • Key history points: Wheeze, have they ever been hospitalised/ITU admission, have they required steroids/rescue pack, nocturnal cough, worse at night, worse at work/better on holiday, atopy, eczema, hayfever, illness (viral/bacteria)
    • Risks of exacerbations: poor inhaler technique, continued triggers, smoking (active vs passive)

    Asthma signs and investigations

    • Wheeze
    • Dry cough (unless infected)
    • Breathlessness (usually acutely, progressive while unwell, responsive to treatment (usually))
    • Not speaking in full sentences (acute)
    • Hypoxia and cyanosis in life-threatening exacerbations

    Peak flow

    • Twice a day
    • Know their best and calculate predicted

    Asthma summary management

    • Peak flow diary
    • Stop smoking/vaping
    • Avoid/limit triggers
    • Vaccinations (Flu)
    • Inhalers: B2 agonist (salbutamol): relief (BLUE) (SABA), steroid: preventer (BROWN) (ICS), long acting B2 agonist (LABA), Combo (Fostair (LABA/ICS), Symbicort (LABA/ICS))
    • CHECK inhaler technique!

    COPD

    • Emphysema & Chronic bronchitis
    • Over a million GP appointments a year
    • Smoking: >80% cause
    • Irreversible airways disease

    Respiratory investigations

    • Bloodwork: Anaemia, infection, eosinophilia, BNP, calcium, thyroid, ?d-dimer, cultures
    • Peak flow: Asthma
    • Spirometry: COPD, asthma, fibrosis
    • Chest X-Ray (CXR): infection, fibrosis, cancer, collapse
    • CT scan: PE, cancer, fibrosis, complex infections
    • Sleep studies/overnight oximetry: Obstructive sleep apnoea
    • ABG: Hypoxia, COPD, Asthma

    Common respiratory conditions with associated investigations

    • Asthma: common, atopic patient, chronic inflammation of the airways, hyper-responsive and reversible, inflammatory cells infiltrate the airways, smooth muscle hypertrophy, thickening of the airway, trigger by pollution, occupational exposure, allergens, bacteria and viruses, cold air
    • COPD: slowly progressive, smoking, low peak flow

    Diagnostic clues:

    • Is it asthma? Variable, wheeze, nocturnal cough, triggers, atopy, low peak flow
    • Is it COPD? Slowly progressive, smoking, low peak flow
    • Is it a pneumothorax? Pleuritic pain, quiet breath sounds, CXR findings
    • Is it a PE? Risk factors (immobility, malignancy, previous PE/DVT), pleurisy, haemoptysis, swollen leg
    • Is it heart failure? Swollen ankles, orthopnoea, crackles, JVP
    • Is it pneumonia? Fever, rigors, pleurisy, productive cough, bronchial breathing, crackles, CXR- Consolidation
    • Is it cancer? Smoking, weight loss, PMH (?secondary cancer)
    • Is it interstitial lung disease? Occupational exposure, hobbies, drugs, crackles, dry cough
    • Sore throat/Rhinorrhoea: Upper respiratory tract infection (URTI)
    • Stridor: Obstruction

    Respiratory sounds

    • Crackles: wet vs dry, coarse
    • Bronchial breathing: hollow sound
    • Wheeze: inspiratory (stridor), expiratory

    Who are these people?

    • Ockham’s Razor: theory that the simplest explanation is the correct one!
    • Hickam’s dictum: ‘A patient can have as many diseases as they damn well please!’
    • Remember that many things might be going on at once, patients often have many co-morbidities!

    Burden of respiratory disease

    • 3rd biggest cause of death
    • Lung cancer
    • COPD
    • Asthma
    • All: £11 billion to the NHS
    • Mortality rates higher in disadvantaged groups

    Respiratory Disease Burden

    • Respiratory diseases are the third biggest cause of death
    • 1 in 5 people are affected by respiratory conditions
    • Increased incidence over winter
    • Asthma: £3 Billion, COPD: £1.9 Billion, total NHS cost: £11 Billion
    • Higher mortality in disadvantaged groups due to smoking, air pollution, poor housing, occupational hazards

    Respiratory Anatomy & Physiology

    • Covers the structure and function of the respiratory system

    Common Respiratory Symptoms & Signs

    • Upper Respiratory Tract: Rhinorrhoea, Nasal congestion, Sore throat
    • Lower Respiratory Tract: Breathlessness, Haemoptysis, Cough (productive/dry/nocturnal), Wheeze (inspiratory/expiratory)
    • Other signs: Cyanosis of lips/earlobes/fingertips, Crackles (wet/dry/coarse), Bronchial breathing (hollow sound)

    Diagnostic Clues

    • Asthma: Variable wheeze, nocturnal cough, triggers, atopy, low peak flow
    • COPD: Slowly progressive, smoking, low peak flow
    • Pneumothorax: Pleuritic pain, quiet breath sounds, CXR findings
    • PE: Risk factors (immobility, malignancy, previous PE/DVT), pleurisy, haemoptysis, swollen leg
    • Heart failure: Swollen ankles, orthopnoea, crackles, JVP
    • Pneumonia: Fever, rigors, pleurisy, productive cough, bronchial breathing, crackles, CXR- consolidation
    • Cancer: Smoking, weight loss, past medical history (secondary cancer)
    • Interstitial lung disease: Occupational exposure, hobbies, drugs, crackles, dry cough
    • Sore throat/Rhinorrhoea: Upper respiratory tract infection (URTI)
    • Stridor: Obstruction

    Ockham's Razor & Hickam's Dictum

    • Ockham's Razor: The simplest explanation is usually the correct one
    • Hickam's Dictum: A patient can have many diseases at the same time

    Respiratory Investigations

    • Bloodwork: Anaemia, infection, eosinophilia, BNP, calcium, thyroid, d-dimer, cultures
    • Peak flow: Asthma
    • Spirometry: COPD, asthma, fibrosis
    • Chest X-Ray (CXR): Infection, fibrosis, cancer, collapse
    • CT Scan: PE, cancer, fibrosis, complex infections
    • Sleep studies/overnight oximetry: Obstructive sleep apnoea
    • ABG: Hypoxia, COPD, Asthma

    Common Respiratory Conditions

    • Describes common respiratory conditions with associated investigations

    Asthma

    • Common, atopic patient
    • Chronic inflammation of the airways
    • Hyper-responsive and reversible
    • Inflammatory cells infiltrate the airways
    • Smooth muscle hypertrophy
    • Thickening of the airway
    • Triggered by pollution, occupational exposure, allergens, bacteria/viruses, cold air

    Asthma History

    • Risk factors: Smoking, family history, childhood infections, pollution, prematurity, occupation (chemicals, dusts, spores)
    • Key history points: Wheeze, hospitalisation, ITU admission, steroid use, rescue pack requirement, nocturnal cough, worse at night, worse at work/better on holiday, atopy (eczema, hayfever), illness, viral/bacterial infections

    Asthma Signs & Investigations

    • Signs: Wheeze, dry cough, breathlessness (acute, progressive), responsive to treatment, not speaking in full sentences (acute), hypoxia and cyanosis in life-threatening exacerbations
    • Investigations: Peak flow (twice a day), bloods (IgE, eosinophils), spirometry (obstructive), CXR, sputum sample

    Asthma Management (Non-acute)

    • Peak flow diary: Monitor control
    • Inhalers:
      • B2 agonist [salbutamol]: Relief
      • Steroid: preventer
      • Long acting B2 agonist (LABA)
      • Combo inhalers (LABA/ICS)
    • Other interventions: Stop smoking/vaping, avoid/limit triggers, vaccinations (flu, Covid), check inhaler technique (use spacer when possible), annual review, tablets if poor control, leukotriene antagonists, theophylline, steroids

    Asthma Phenotypes

    • There are different types of asthma

    BTS/SIGN Asthma Guidelines

    • Provide guidance on managing asthma

    Asthma Management Principles

    • Consider triggers (allergies, occupation)
    • Ensure concordance (engagement) and check inhaler technique
    • Control inflammation with inhaled steroids
    • Use long acting B2 agonists (ICS/LABA inhalers)
    • Consider leukotriene receptor antagonists, theophyllines, long acting anticholinergics (tiotropium)

    Nebulisers

    • Used in asthma and COPD
    • Contents: Salbutamol 2.5mg, Ipratropium 500 micrograms, Saline nebs
    • Used for specific antibiotics in CF/bronchiectasis (Colomycin, gentamicin)

    Spacers

    • 10 puffs in a spacer is the same as a neb
    • No need for patients to buy expensive machines

    Advanced Asthma Treatment

    • IgE-driven disease: Anti IgE (omalizumab)
    • Eosinophil-driven disease: Anti IL-5 (mepolizumab...), Anti IL-4 alpha subunit
    • Bronchial thermoplasty: Treatment for severe asthma

    Asthma Discharge Checklist

    • Provides information for patients leaving hospital following an asthma admission

    Peak Flow

    • Common measure of airflow in and out of the lungs
    • Monitors asthma control
    • Guides assessment of asthma exacerbation severity

    Peak Flow Recording

    • Stand up, deep breath in, seal mouth, short exhale, best of three attempts
    • Record twice a day
    • Patients know their usual PEFR
    • Predicted based on height

    Acute Asthma Severity

    • There are different levels of asthma severity in acute presentations

    Emphysema & Chronic Bronchitis

    • COPD: Emphysema and Chronic bronchitis combined
    • Chronic productive cough for at least 2 consecutive years
    • 2nd commonest cause of hospital admission
    • Over 1 million GP appointments a year
    • Irreversible airways disease
    • 80% caused by smoking

    Main Problems with COPD

    • Details the key issues associated with COPD

    Introduction

    • Respiratory diseases are the 3rd leading cause of death.
    • One in five people are affected by respiratory diseases.
    • Respiratory diseases are a significant burden on the NHS, costing £11 billion annually.
    • Mortality rates are higher in disadvantaged groups due to factors like smoking, air pollution, poor housing, and occupational hazards.

    Common Respiratory Conditions & Symptoms

    • Upper Respiratory Tract
      • Rhinorrhea (runny nose)
      • Nasal Congestion
      • Sore Throat
    • Lower Respiratory Tract
      • Breathlessness
      • Haemoptysis (coughing up blood)
      • Cough (productive/dry, nocturnal)
    • Signs
      • Cyanosis (blue discoloration of lips, earlobes, fingertips)
      • Crackles in the lungs (wet/dry, coarse)
      • Bronchial breathing
      • Wheeze (inspiratory/expiratory)

    Diagnostic Clues

    • Asthma
      • Variable symptoms,wheeze, nocturnal cough, triggers, atopy (allergies), low peak flow
    • COPD
      • Slowly progressive, smoking history, low peak flow
    • Pneumothorax
      • Pleuritic pain (sharp chest pain), quiet breath sounds, chest X-ray findings
    • Pulmonary Embolism (PE)
      • Risk factors: Immobility, malignancy, previous PE/DVT, pleurisy, haemoptysis, swollen leg
    • Heart Failure
      • Swollen ankles, orthopnea (difficulty breathing when lying down), crackles, JVP (jugular venous pressure)
    • Pneumonia
      • Fever, rigors (shivering), pleurisy, productive cough, bronchial breathing, crackles, consolidation on chest X-ray
    • Cancer
      • Smoking history, weight loss, previous history of cancer
    • Interstitial Lung Disease
      • Occupational exposure, hobbies, medications, crackles, dry cough
    • Sore throat/Rhinorrhea
      • Upper Respiratory Tract Infection (URTI)
    • Stridor
      • Obstruction

    Ockham’s Razor and Hickam’s Dictum

    • Ockham’s Razor: The simplest explanation is often the correct one.
    • Hickam’s Dictum: A patient can have as many diseases as they damn well please.

    Respiratory Investigations

    • Bloodwork
      • Anaemia, infection, eosinophilia (elevated eosinophils), BNP (brain natriuretic peptide), calcium, thyroid, D-dimer, cultures
    • Peak Flow
      • Used to monitor asthma control
    • Spirometry
      • COPD, asthma, fibrosis
    • Chest X-Ray (CXR)
      • Infection, fibrosis, cancer, collapse
    • CT Scan
      • PE, cancer, fibrosis, complex infections
    • Sleep Studies/Overnight Oximetry
      • Obstructive sleep apnea
    • ABG (Arterial Blood Gas)
      • Hypoxia (low oxygen levels), COPD, asthma

    Asthma

    • Common atopic (allergic) condition
    • Chronic inflammation of the airways, causing hyperresponsiveness and reversibility
    • Inflammatory cells infiltrate the airways
    • Smooth muscle hypertrophy (thickening)
    • Thickening of the airway wall
    • Triggers: Pollution, occupational exposure, allergens, virus/bacteria, cold air

    Asthma History

    • Risk factors:
      • Smoking
      • Family history
      • Childhood infections
      • Pollution
      • Prematurity
      • Occupation (chemicals, dusts, spores)
    • Key history points:
      • Wheeze
      • Hospitalization/ITU admissions
      • Use of steroids/rescue inhalers
      • Nocturnal cough
      • Worsening symptoms at night
      • Improvement on holiday
      • Atopy (eczema, hayfever)
      • Exacerbation risks: Poor inhaler technique, continued triggers, smoking, illness

    Asthma Signs & Investigations

    • Signs:
      • Wheeze
      • Dry cough (unless infected)
      • Breathlessness (acute or progressive)
      • Responsive to treatment (usually)
      • Difficulty speaking in full sentences (acute)
      • Hypoxia and cyanosis during severe exacerbations
    • Investigations:
      • Peak flow (twice daily)
      • Bloods: IgE, eosinophils
      • Spirometry (obstructive pattern)
      • Chest X-ray
      • Sputum sample

    Asthma Management (Not Acute)

    • Peak flow diary: Monitoring control
    • Inhalers:
      • Short-acting beta-agonist (SABA) (salbutamol): Relief
      • Inhaled corticosteroids (ICS): Prevention
      • Long-acting beta-agonist (LABA)
      • Combined inhalers (ICS/LABA)
    • Other interventions:
      • Smoking cessation
      • Avoidance/limitation of triggers
      • Vaccinations (influenza, COVID)
      • Annual review
    • Other medications:
      • Leukotriene antagonists
      • Theophylline
      • Steroids (oral)

    Asthma Phenotypes

    • Different asthma phenotypes (types) exist.

    BTS/SIGN Asthma Guidelines

    • Consider triggers: Allergies and occupation.
    • Ensure concordance and correct inhaler technique.
    • Control inflammation with inhaled steroids, long-acting beta-agonists, leukotriene receptor antagonists, theophylline, and long-acting anticholinergics (tiotropium).

    Nebulisers

    • Used in asthma and COPD
    • Commonly used medications in a nebulizer: Salbutamol, ipratropium bromide, saline
    • Used for certain antibiotics in cystic fibrosis and bronchiectasis

    Importance of Spacers

    • Using a spacer with an inhaler can be as effective as a nebulizer.

    Advanced Asthma Treatments

    • IgE-driven disease:
      • Anti-IgE therapy (omalizumab)
    • Eosinophil-driven disease:
      • Anti-IL5 therapy (mepolizumab, etc.)
      • Anti-IL4 alpha subunit therapy
    • Bronchial thermoplasty:
      • Heat treatment to reduce airway smooth muscle mass

    Asthma Discharge

    • Patients should be provided with a discharge checklist to ensure understanding of their condition and management

    Peak Flow

    • Used to monitor asthma control.
    • Simple measurement of air flow in and out of the lungs.
    • Can help assess asthma exacerbation severity.
    • Recommendations:
      • Record standing upright.
      • Deep breath in, form a seal around the mouth, short, sharp breath out.
      • Perform three attempts and record the highest reading.
      • Record twice daily.
      • Patients should know their usual peak flow readings.
      • A predicted peak flow can be calculated based on height.

    Acute Asthma Severity

    • Severity of an acute asthma exacerbation can be classified using guidelines.

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