referral criteria from primary care - acute asthma
Last reviewed 01/2018
Criteria for admission include:
- any features of a life-threatening or near-fatal asthma attack
- any features of a severe attack that persist after initial treatment
- patients whose peak flow is greater than 75% best or predicted one hour after initial treatment may be discharged from ED unless they meet any of the following criteria, when admission may be appropriate:
- still have significant symptoms
- concerns about adherence
- living alone/socially isolated
- psychological problems
- physical disability or learning difficulties
- previous near-fatal asthma attack
- asthma attack despite adequate dose steroid tablets prior to presentation
- presentation at night
- pregnancy
A lower threshold for admission is appropriate in patients:
- seen in the afternoon or evening rather than earlier in the day
- with recent onset of nocturnal symptoms or worsening of symptoms
- who have had previous severe attacks, especially if the onset was rapid
- in whom there is concern over their assessment of severity of symptoms
- in whom there is concern over the social circumstances or relatives' ability to respond appropriately (1)
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