British guideline on the management of asthma: SIGN Clinical Guideline 141, 2014

David R James,Mark D Lyttle

doi:10.1136/archdischild-2015-310145

Abstract

### Clinical bottom line This latest revision of national guidance on asthma management was produced jointly by the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) in...

Highlights

Key recommendations from British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) guidance (NICE Quality Standard (QS) in italics where applicable) Diagnosis When assessing children for a potential diagnosis of asthma, focus on key features in the history and examination and consider alternative diagnoses – stratify the likelihood of asthma as high, intermediate or low probability and document the reason for this clearly Supported Self Management Offer children with asthma self-management education, and offer parents/carers education on managing their child’s asthma
Include a written personalised asthma action plan (PAAP) (Box 1) and support this with regular professional review Give patients written PAAPs before discharge; this should be done by healthcare professionals with expertise in providing asthma education (Box 1) Assess adherence to long-term asthma treatment regularly; every clinical encounter presents an opportunity to do so (Box 2)
Monitor height and weight annually Follow current stepwise management of asthma to optimise interval symptoms and prevent asthma attacks, with regular review of adherence Use inhaled salbutamol as first line treatment in asthma attacks coupled with early administration of oral steroids, add ipratropium bromide every 20-30 minutes for the first two hours in severe attacks Utilise each healthcare encounter as an opportunity to review and monitor asthma symptoms and treatment (Box 2)

Summary

Introduction

Key recommendations from BTS/SIGN guidance (NICE QS in italics where applicable) Diagnosis When assessing children for a potential diagnosis of asthma, focus on key features in the history and examination and consider alternative diagnoses – stratify the likelihood of asthma as high, intermediate or low probability and document the reason for this clearly Supported Self Management Offer children with asthma self-management education, and offer parents/carers education on managing their child’s asthma.

Results

Conclusion