T1 – Introduction

Asthma is the commonest chronic childhood condition in the UK, affecting 1 in 11 children.  It is one of the commonest reasons for emergency admission.  Almost 50% of pre-school children will have had one significant episode of wheezing, often triggered by a viral respiratory infection.  Of that 50% however, most will be symptom-free by the age of 6. 

Asthma is a clinical diagnosis, based on recurrent episodes of wheezing / chest tightness / breathlessness, with variable expiratory airflow obstruction.  The condition is characterised by a hyper-responsiveness of the airways to a variety of triggers (including viruses, allergens such as pollens, irritants such as tobacco smoke). 

However it is also worth remembering that not all wheeze is asthma… 

The management of chronic asthma is complex and outside of the remit of this minor illness course. 

There are extensive guidelines about asthma management published by the British Thoracic Society, NICE, and the Scottish organisation SIGN.  They are working towards producing a joint guideline but that is not yet available.  I find the SIGN guideline quite accessible, so here is a link if you want to have a look for yourself: 

https://www.sign.ac.uk/our-guidelines/british-guideline-on-the-management-of-asthma/

For this course, we will just focus on the assessment and initial management of an acute asthma presentation.