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hma
Asthma
A sth m a is a ch ronic inflam m atory d isord er of th e airw ays associated w ith airw ay
h yper- responsiv eness th at lead s to recurrent episod es of w h eezing , breath lessness,
ch est tig h tness and coug h ing . T h ese episod es are usually associated w ith airflow
obstruction w ith in th e lung , often rev ersible, eith er spontaneously or w ith treatm ent.
F actors th at precipitate/ ag g rav ate asth m a includ e: allerg ens, infection, exercise, d rug s
(aspirin), tobacco, etc.
In young ch ild ren, m ost initial episod es of asth m a-like sym ptom s are associated w ith a
respiratory tract infection, w ith no sym ptom s betw een infections. W h eezing episod es
usually becom e less frequent w ith tim e; m ost of th ese ch ild ren d o not d ev elop asth m a.
Asthma attack (acute asthma)
A sth m a attack is a substantial w orsening of asth m a sym ptom s. T h e sev erity and
d uration of attacks are v ariable and unpred ictable.
Assessment of the severity of asthma attack
T h e sev erity of th e asth m a attack m ust be rapid ly ev aluated by th e follow ing clinical
criteria. N ot all sig ns are necessarily present.
Assessment of severity in children under 2 years and adults
MILD TO MODERATE ATTACk SEVERE ATTACk LIf E THREATENINg ATTACk
Able to talk in sentences Cannot complete sentences Altered level of consciousness
in one breath (d row siness, confusion, com a)
Respiratory rate (RR) or
C h ild ren 2 -5 years ≤ 4 0 / m in Too breathless to talk or feed Exhaustion
C h ild ren > 5 years ≤ 3 0 / m in
RR Silent chest
Pulse C h ild ren 2 -5 years > 4 0 / m in
C h ild ren 2 -5 years ≤ 1 4 0 / m in C h ild ren > 5 years > 3 0 / m in Paradoxical
C h ild ren > 5 years ≤ 1 2 5 / m in A d ults ≥ 2 5 / m in thoracoabdominal movement
and Pulse Cyanosis
No criteria of severity
C h ild ren 2 -5 years > 1 4 0 / m in
C h ild ren > 5 years > 1 2 5 / m in Collapse
A d ults ≥ 1 1 0 / m in
Bradycardia in children or
O2 saturation ≥ 92% arrhythmia/hypotension in
adults
O2 saturation < 92%
74
Asthma
A sth m a is a ch ronic inflam m atory d isord er of th e airw ays associated w ith airw ay
h yper- responsiv eness th at lead s to recurrent episod es of w h eezing , breath lessness,
ch est tig h tness and coug h ing . T h ese episod es are usually associated w ith airflow
obstruction w ith in th e lung , often rev ersible, eith er spontaneously or w ith treatm ent.
F actors th at precipitate/ ag g rav ate asth m a includ e: allerg ens, infection, exercise, d rug s
(aspirin), tobacco, etc.
In young ch ild ren, m ost initial episod es of asth m a-like sym ptom s are associated w ith a
respiratory tract infection, w ith no sym ptom s betw een infections. W h eezing episod es
usually becom e less frequent w ith tim e; m ost of th ese ch ild ren d o not d ev elop asth m a.
Asthma attack (acute asthma)
A sth m a attack is a substantial w orsening of asth m a sym ptom s. T h e sev erity and
d uration of attacks are v ariable and unpred ictable.
Assessment of the severity of asthma attack
T h e sev erity of th e asth m a attack m ust be rapid ly ev aluated by th e follow ing clinical
criteria. N ot all sig ns are necessarily present.
Assessment of severity in children under 2 years and adults
MILD TO MODERATE ATTACk SEVERE ATTACk LIf E THREATENINg ATTACk
Able to talk in sentences Cannot complete sentences Altered level of consciousness
in one breath (d row siness, confusion, com a)
Respiratory rate (RR) or
C h ild ren 2 -5 years ≤ 4 0 / m in Too breathless to talk or feed Exhaustion
C h ild ren > 5 years ≤ 3 0 / m in
RR Silent chest
Pulse C h ild ren 2 -5 years > 4 0 / m in
C h ild ren 2 -5 years ≤ 1 4 0 / m in C h ild ren > 5 years > 3 0 / m in Paradoxical
C h ild ren > 5 years ≤ 1 2 5 / m in A d ults ≥ 2 5 / m in thoracoabdominal movement
and Pulse Cyanosis
No criteria of severity
C h ild ren 2 -5 years > 1 4 0 / m in
C h ild ren > 5 years > 1 2 5 / m in Collapse
A d ults ≥ 1 1 0 / m in
Bradycardia in children or
O2 saturation ≥ 92% arrhythmia/hypotension in
adults
O2 saturation < 92%
74
