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British Guideline on the MAnAGeMent of AsthMA 16 Figure 2: Presentation with suspected asthma in adults HIGH PROBABILITY: diagnosis of asthma likely Continue treatment Trial of treatment* Presentation with suspected asthma Clinical assessment including spirometry (or PEF if spirometry not available) FEV 1 / FVC 0.7 Further investigation. Consider referral LOW PROBABILITY: other diagnosis likely Investigate/ treat other condition Response? � Response? Yes No No Yes Continue treatment * See section 2.5.1 � See Table 6
Table 6: Differential diagnosis of asthma in adults, according to the presence or absence of airflow obstruction (FEV 1 /FVC 1 x 109 /l) Poor response to asthma treatment Severe asthma exacerbation 2 diAGnosis 17
Page 1 and 2: 101 British Guideline on the Manage
Page 3 and 4: British Thoracic Society Scottish I
Page 5 and 6: Revised 2011 Revised 2011 Revised 2
Page 7 and 8: 1 introduction 1.1 the need for A G
Page 9 and 10: 1.3.1 PATIENT vERSION Patient versi
Page 11 and 12: Table 1: Clinical features that inc
Page 13 and 14: Case detection studies have used sy
Page 15 and 16: 2.1.6 CHILDREN WITH AN INTERMEDIATE
Page 17 and 18: 2.3 suMMAry focus the initial asses
Page 19 and 20: 2.4 diAGnosis in Adults The diagnos
Page 21: 2.4.1 FURTHER INvESTIGATION OF PATI
Page 25 and 26: 2.5.1 TREATMENT TRIALS AND REvERSIB
Page 27 and 28: A small prospective observational s
Page 29 and 30: Table 8: Summary of tools that can
Page 31 and 32: Measurement Methodology Asthma Cont
Page 33 and 34: Measurement Methodology Eosinophil
Page 35 and 36: 3.1.2 FOOD ALLERGEN AvOIDANCE Sensi
Page 37 and 38: The limited data on antenatal or ea
Page 39 and 40: 3.3.2 AIR POLLUTION Challenge studi
Page 41 and 42: 3.5 CoMPleMentAry And AlternAtive M
Page 43 and 44: Revised 2011 4 Pharmacological mana
Page 45 and 46: Table 8b: Equivalent doses of inhal
Page 47 and 48: 4.2.3 SAFETy OF INHALED STEROIDS Th
Page 49 and 50: 4.3.2 ADD-ON THERAPy Options for ad
Page 51 and 52: 4.4 steP 4: Poor Control on ModerAt
Page 53 and 54: 4 PhArMAColoGiCAl MAnAGeMent Colchi
Page 55 and 56: MOVE UP TO IMPROVE CONTROL AS NEEDE
Page 57 and 58: 4.6 stePPinG doWn Stepping down the
Page 59 and 60: 4.7.5 ASPIRIN-INTOLERANT ASTHMA The
Page 61 and 62: 5.3 inhAled steroids for stABle Ast
Page 63 and 64: Revised 2009 6 Management of acute
Page 65 and 66: Patients with brittle or difficult
Page 67 and 68: Table 11: Initial assessment - the
Page 69 and 70: In acute asthma without life threat
Page 71 and 72: 6.3.8 ANTIBIOTICS 6.3.9 HELIOx When
Page 73 and 74:
6.6.2 PATIENT EDUCATION Following d
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6.7.2 PULSE OxIMETRy 6.7.3 PEF Accu
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Frequent doses up to every 20-30 mi
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6.9.3 Iv MAGNESIUM SULPHATE Intrave
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New 2011 7 special situations 7.1 A
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Gender During adolescence there is
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Complementary and alternative medic
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Table 13: Recommendations for organ
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7.2 diffiCult AsthMA 7.2.1 DEFINING
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Revised 2009 Controlled studies usi
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Continuous fetal monitoring should
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C use steroid tablets as normal whe
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7.9.2 AT-RISK POPULATIONS Several h
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7.9.6 SPECIFIC BRONCHIAL PROvOCATIO
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Asthma clinics in primary care may
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A 8.3 Audit discharge from hospital
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9 Patient education and self manage
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9.2.1 COMPLIANCE WITH MONITORING AN
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Table 15. Summary of the key compon
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8. What role does patient preferenc
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Dr James Paton* Reader and Honorary
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INHALER DEvICES Dr John White (Chai
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11.4 disseMinAtion GrouP Mrs Sheila
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Abbreviations ABG arterial blood ga
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Annex 2 Management of acute severe
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Annex 4 Features of acute severe as
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Annex 6 Consider prednisolone 20 mg
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Annex 8 Management of acute asthma
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Annex 10 PEF (l/min) EU Scale 680 6
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Annex 11 (contd) Annexes 125
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56. Abu-Hasan M, Tannous B, Weinber
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156. Lodrup Carlsen KC, Carlsen KH,
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256. Malmstrom M, Ahlner J, Carlsso
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352. Brocklebank D, Ram F, Wright J
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456. McDowell KM, Chatburn RL, Myer
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562. McDonald JC, Keynes HL, Meredi
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668. Enright PL, McClelland RL, New
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767. Berger W. Budesonide inhalatio
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862. Pedroletti C, Lundahl J, Alvin
Page 151:
ISBN 978 1 905813 28 5 British Thor
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