An exacerbation is a deterioration in the level of control experienced by a person with asthma. The level and duration of
Keywords: Asthma exacerbation/Hypoxaemia/Asthma self-management●This article has been double-blindpeer reviewed
5 keypoints
1
Asthma is
inflammation
of the airways
associated
with hyperresponsiveness
of the airway
smooth muscle
2Exacerbations
of asthma can
occur frequently
and have a number
of causes, the most
common being
viral infections
3When
presenting with
exacerbations,
patients should
be assessed so
appropriate
management can
be planned
4Follow up
should be
carried out to
ensure recovery is
taking place and to
facilitate patient
education
5Patients with
a written
asthma action plan
tend to have fewer
exacerbations
Some acute asthma exacerbations occur
without an identifiable cause
deterioration is important and a full history
should be obtained to help identify
whether the person is normally well – has
the asthma been like this for a period of
weeks or months or, if is it are usually well
controlled, has a loss of control happened
over the past few days? Both of these scenarios
may have similar, if not identical,
clinical presentations. Tattersfield et al
(2004) found the pattern of deterioration
in 425 exacerbations started around eight
days before presentation and that it took a
similar amount of time to get back to the
previous level of control.
Current UK guidelines published by the
British Thoracic Society and the Scottish
Intercollegiate Guideline Network categorise
exacerbations of asthma as moderate,
severe and life threatening, based on the
features with which patients present (BTS
and SIGN, 2012) (Table 1).