An overview of pre-hospital care for patients presenting with asthma exacerbations

What is it about?

Asthma is characterised by shortness of breath, productive or non-productive cough, wheezing and a feeling of chest tightness. Emergency hospital admissions for asthma are costly to health services and it is estimated 75% are avoidable through effective management and preventative care. This article provides an overview of asthma management in prehospital care setting, including physiological considerations.

Featured Image

Why is it important?

Worsening asthma and severe asthma exacerbations challenge clinicians in the pre-hospital setting because of the need for early recognition, the potential for rapid deterioration and the need for timely treatment & transport to an appropriate hospital. Despite early recognition and intervention, some patients will fail to respond to therapy, continue to deteriorate or present with a life-threatening event. Differentiating asthma from other respiratory presentations is based upon recognition of the characteristics of an asthma event. If asthma does not appear likely, the clinical history should also explore other possible causes of the symptoms and steer the clinician accordingly. Wheezing associated with asthma and upper respiratory infections cannot be well distinguished in a young child and it is important that clinicians consider this in making decisions on treatement. Clinicians can also be faced with patients presenting with asthma symptoms, but not necessarily with a diagnosis of asthma. There is a clear need for a good respiratory system assessment to ensure patients are treated & referred appropriately.