Asthma review

Question 1

how often should asthma review/follow-up be performed

Answer 1

annually
more if indicated
4-8wks following med change
48hrs post exacerbation

Question 2

information gathering in reviews

Answer 2

Assessment of asthma symptoms

Objective tests of lung function

Current treatment

Inhaler technique & frequency

Asthma attacks

Smoking/weight loss status

Comorbidities and other medications

Immunisation status

Growth (children)

Anxiety and depression

Question 3

your asthma is managed well when (3) and therefore should check for (1)

Answer 3

• no symptoms // not used inhaler in last 12 wks // high personal peak flow
• dose reduction

Question 4

asthma control is getting worse when

Answer 4

symptoms are coming back (wheeze, tight chest, SOB, cough)
waking up at night
symptoms interfering with day2day activities
drop on PEFR

Question 5

safety-net for signs of attack

Answer 5

inhaler use more than every 4 hours/reliever not helping
difficult to walk & talk
difficult to breathe
wheezing/coughing a lot
tight chest

Question 6

what to do in an attack

Answer 6

sit up straight, try to stay calm
up to 10 puffs reliever inhaler
if u feel worse or not better after 10 puffs –> 999
if no ambulance in 10 mins repeat step 2
999 again

Question 7

advice on discharge

Answer 7

if attack at home –> see GP today
if attack in hospital –> see GP within 48hrs
finish any meds they prescribe you even if you feel better
come back if you get worse or don’t improve within 7 days

Question 8

questions to assess asthma control

Answer 8

asthma symptoms during the day?
difficulty sleeping because of symptoms?
interference with daily activities?
how often using blue inhaler?
taking medication as prescribed?
had a previous attack?
currently smoke? ever smoked?
asthma effect on mood?