BMJ Best Practice Podcast Asthma
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Dec 17, 2024 In this engaging discussion, Richard Russell, Specialty Registrar in Respiratory Medicine at Glenfield Hospital, sheds light on the rising global crisis of acute asthma, affecting 300 million people. He emphasizes the preventability of asthma-related deaths, which number around 180,000 yearly. The conversation dives into effective diagnosis methods, including objective measurements and recognizing complex symptoms, as well as tailored management strategies for high-risk patients. Russell also explores the interplay between asthma and comorbidities like heart failure and diabetes.
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Defining Asthma Exacerbations
- An asthma exacerbation, or attack, occurs when symptoms worsen beyond usual variability.
- Common triggers include viral infections, allergens, and environmental exposures like smoke or dust.
Diagnosing Asthma Exacerbations
- Diagnose asthma exacerbations based on reported symptoms (cough, breathlessness, wheeze, chest tightness) and physical signs (tachycardia, tachypnea, cyanosis, wheeze).
- Assess airflow obstruction using peak expiratory flow (PEF) to determine severity.
Peak Flow and Severity
- Use the patient's known normal peak flow as a baseline.
- Grade exacerbation severity based on PEF percentage: 50-75% (moderate), 33-50% (severe), <33% (life-threatening).