The best strategy for management of acute exacerbations of asthma is early recognition and intervention, before attacks become severe and potentially life-threatening. Detailed investigations into the circumstances surrounding fatal asthma have frequently revealed failures on the part of both patients and clinicians to recognize the severity of the disease and to intensify treatment appropriately .
The management of acute asthma exacerbations will be presented here. An overview of asthma management, the identification of risk factors for fatal asthma, and the use of mechanical ventilation in severe exacerbations of asthma are discussed separately. (See "An overview of asthma management" and "Identifying patients at risk for fatal asthma" and "Invasive mechanical ventilation in adults with acute exacerbations of asthma".)
ALGORITHMS FOR ASSESSMENT AND TREATMENT
The National Asthma Expert Panel has published useful algorithms on the management of acute exacerbations of asthma for both the home and acute care settings (algorithm 1 and algorithm 2) . These algorithms may be used for asthma exacerbations of any severity. A table outlining the emergency management of severe asthma exacerbations in adults is also provided (table 1).
The basic principles of care are the following:
●Assess the severity of the attack