Acute asthma exacerbations: tips from the shop floor

Asthma places a significant burden on acute and non-acute services and is frequently encountered in the emergency department and the medical take. The UK has one of the highest asthma mortality rates in Europe. The National Review of Asthma Deaths has identified multiple factors that have contributed to preventable asthma deaths and solutions to these factors, including a better understanding and implementation of asthma guidelines. The British Thoracic Society and Scottish Intercollegiate Guidelines Network have recently updated their guidance on the management of asthma. This article outlines the guidelines for junior doctors managing patients with acute exacerbations of asthma. It highlights key areas of the initial assessment, establishing severity and initiating and escalating treatment. Furthermore, the discharge process from discharge criteria to promoting patient safety, education and ongoing self-management is discussed. This process, in particular education and personalised asthma action plans, can make a significant difference to the patient's outcomes and day-to-day burden of symptoms.