trigger. Little can be done here, apart from
reinforcing appropriate behaviours and, if
there has been delay in seeking help,
advising using a written action plan. The
biggest cause of asthma exacerbations is
viral infections (Wark and Gibson, 2006).
Inhaled corticosteroids
A proven way to reduce exacerbations is
through the use of ICS (Fitzgerald and
Gibson, 2006). BTS and SIGN (2012) advocate
prescribing these where patients have
had an exacerbation requiring OCS in the
past two years. It is essential to prescribe
ICS for patients who present with an acute
exacerbation and are not receiving them.
A number of studies have found that
patients with written asthma action plans
have fewer exacerbations, less time off
work, use reliever medication less, have
better adherence with ICS, and have better
lung function (Gibson and Powell, 2004).
Conclusion
Acute asthma exacerbations are common.
Causes are varied, ranging from viral infections
to people who may be “exacerbationprone
phenotypes”. Guidelines advise a
thorough assessment followed by standard
treatment with oxygen where necessary,