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asthma (treatment (environmental control (avoid passive smoking, reduce…

- - - - SABA + ICS(very low)
        
        add LABA (>5y) or leukotrienne receptor anatgonist (<5y)
        
        over 5y - responds to LABA, cont LABA and incr ICS (low dose); if doesn't, stop LABA and incr ICS (low dose). Can consider LTRA
        
        Consider incr ICS (med dose); addition of fourth drug SR theophylline; refer to paeds
        
        oral steroids
        
        under 5y, refer to paeds.. ?incr ICS. LABA not licensed
  - - - 6 puffs 100mcg salbutamol via spacer
        
        repeat if indicated
      - consider prednisolone 1mg/Kg
    - - oxygen if Sa02 <92%
      - salbutamol 6 puffs 100mcg every 20mins for up to 1h
      - prednisolone 1mg/Kg
    - - oxygen
      - salbutamol 6 puffs 100mcg via spacer or 5mg nebule every 20mins for up to 1h
      - ipratropium bromide 4 puffs 20mcg via spacer or 0.25mg nebule. Every 20 mins (max 3 doses 1 hour)
      - prednisolone 1mg/Kg (max 40mg)
      - magnesium sulphate
      - IV aminophylline
- - - - triggers
      - time of day
    - - how severe was the worst one?
    - - was it effective?
  - - - cough at night
      - SOB exercise
      - early morning symptoms
      - amount of reliever use
      - amount of oral steroid use
  - - - breathless but not distressed
      - PEFR reduced but >50% normal
    - - too breathless to talk or feed
      - RR>50 HR>130
      - PEFR<50% expected
    - - PEFR<33% expected
      - "silent chest" or cyanosis
      - fatigue, drowsiness, confusion
      - hypotension