Diagnosis of asthma in children
The diagnosis of asthma in children, young people or even in adults needs a medium-to long-term view. In under 5s particularly, it requires a confident health professional to support parents with the uncertainty of cause until confirmation-or not-of an asthma diagnosis. Under 5s cannot generally give a concise history when questioned, or perform helpful investigations such as spirometry. The differential diagnoses in children are numerous and must be considered while establishing asthma as a cause of symptoms. It is wise to at least attempt spirometry form the age of 5 years upwards as many will be able to perform it, given time and instruction. For the under 5s it is prudent to work closely with their GP to rule out other possible causes of symptoms and to consider whether a referral to a specialist is required. Practice nurses who are responsible for making the diagnosis of asthma in children should refer to the British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) Guidelines (2014) and have a low threshold for seeking advice.