The main index of severity in intermittent asthma, is the severity of attacks, in particular the worst ever attack.
The frequency of episodes is not usually a useful measure of severity, as this is primarily due to the frequency of virus respiratory infections, which can be due to factors other than the asthma.
These children get asthma not only with virus respiratory infections, but also in the intervals between virus-triggered episodes. The interval symptoms are triggered by exercise, night time, cold or dry air exposure, and allergen exposure.
Children are usually atopic.
The severity of persistent asthma has been classified as:
A large number of patients underestimate their asthma control. Close questioning can often revel this.
History - ask about:
Examination - look for:
Lung function measurements cannot be readily used to guide asthma management in children under 5 years of age
Reliable monitoring with peak flow meters (even in clinical drug trials) is poor. There is little evidence of their value as a long-term monitoring tool, but this does not negate the use of home monitoring and charting at critical times. These include, for example:
Another way this can me assessed is use a standardised short questionnaire such as the Asthma Control Test.
Although asthma is a clinical diagnosis spirometry can be a valuable aid in diagnosis in children old enough to manage this test (6 and older). Asthma centre offers this service for free.
Asthma & Respiratory Management BOP Inc
BOP Asthma Clinics
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