Assessment of Asthma attacks

The severity of an asthma attack can vary. Different guidelines use different criteria to define the severity of an asthma attack. However, there are three broad categories

Mild

Able to talk in full sentences
Slight wheeze
Peak flow > 50% (best or predicted)

Moderate

Talking in short sentences/phrases
Loud wheeze
Peak flow < 50% (best or predicted)

Severe

Reduced level of consciousness
Unable to speak
Cyanosis (blueish tinge to lips / fingernails)
Wheeze may be absent (‘silent chest’)
Exhaustion

Peak flow readings

A peak flow device is used to monitor how well asthma patients are responding to treatment. Patients with asthma may carry a peak flow device with them to enable them to monitor their breathing.

Asthma patients should know their normal best peak flow reading.

Peak Flow Devices are found inside Ambulance Bags & Diagnostic Kits

Taking a PEF measurement

Ask the patient to stand (or to sit upright if standing is difficult).
Hold the peak flow meter in a horizontal position with the marker aligned to zero.
Take care not to obstruct the meter indicator when holding it.
Take a deep breath in (as fully as possible).
Place the PEF meter mouthpiece in the mouth, behind the teeth, sealing the lips firmly around the mouthpiece.
Blow out as hard and fast as possible.
Note the reading and repeat the measurement 2 more times (further blows should be done if the highest two readings are not within 40L/min of each other).
Record the best of the 3 readings.

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