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Management of exacerbations

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The publication of the Asthma Quality Standards from NICE last month, highlights the importance of recognising how significant an asthma exacerbation can be and the need for fast and effective reviews for those who have suffered an exacerbation. The standard states that people who have suffered an exacerbation that has required input from secondary care or the out-of-hours service should be reviewed by their GP practice within 48 hours.

This is desirable, since most exacerbations could be avoided with early intervention. Seeing the patient soon after an exacerbation allows nurses to address reasons for the exacerbation when the event is fresh in the patient's mind. This article will investigate how to assess a patient presenting with an exacerbation of asthma. This will include how to define the severity of the exacerbation as this will determine the level of intervention required.

Good asthma control is defined as 'freedom from symptoms on minimum amounts of medication and without the need for reliever therapy' but only 5 per cent of asthma patients have guideline defined well controlled asthma.

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