Management Of Acute Severe Asthma Research Articles

A prospective comparative study of efficacy of intravenous magnesium sulfate infusion versus placebo, as an adjuvant to nebulized salbutamol in the management of acute exacerbations of chronic obstructive pulmonary disease

Background: Acute exacerbations of chronic obstructive pulmonary diseases (AECOPD) are a frequent cause of hospitalization, morbidity, and mortality and require serious medical attention. Much research has demonstrated the beneficial effects of intravenous and nebulized magnesium sulfate (MgSO4) as a bronchodilator, in the management of acute severe asthma. Nevertheless, the extent of the benefits of intravenous MgSO4 as an adjuvant to bronchodilators in AECOPD remains uncertain. Therefore, the current study aims to address this gap in knowledge. Aims and Objectives: The study aimed to compare the effectiveness of intravenous magnesium sulfate (MgSO4) versus placebo when used as an adjuvant to nebulized salbutamol in managing AECOPD. Materials and Methods: In this comparative prospective interventional, parallel-group, placebo-controlled study, a total of 60 subjects were assigned to two groups consisting of 30 individuals each. The allocation was non-randomized and open-label, with one group receiving intravenous MgSO4 as an adjuvant to nebulized salbutamol, while the other group received a placebo in the same manner. The evaluation of MgSO4 efficacy involved measuring the peak expiratory flow rate (PEFR), which served as the primary outcome parameter. PEFR measurements were taken at 0, 15, 30, and 45 min to assess the effectiveness of MgSO4. Safety and tolerability of MgSO4 were assessed based on changes in heart rate, blood pressure, deep tendon reflexes, and respiratory rate. Results: At 45 min, the mean change in PEFR was significantly higher (P = 0.061) in the MgSO4 group (178.33 ± 49.18) compared to the placebo group (155.43 ± 41.86). Moreover, the mean difference in PEFR between the two groups was consistently higher in the MgSO4 group at every observation. MgSO4 showed considerable safety and tolerability in subjects based on the postmedication monitoring of hypermagnesemia symptoms. Conclusion: Administering intravenous magnesium sulfate (MgSO4) as an adjuvant to bronchodilators in AECOPD led to the improvement of both clinical condition and PEFR. In AECOPD, MgSO4 exhibits enhanced early bronchodilator response when combined with other drugs, demonstrating significant efficacy, good safety, and tolerability at the prescribed dosage.

COMPARATIVE ANALYSIS ON NON-VENTILATORY MANAGEMENTS IN ACUTE ASTHMA

Introduction: Acute asthma attacks or acute asthma can be defined as episodes of progressive increase in shortness of breath, cough, wheezing, chest tightness, or some combination of these symptoms. It includes the aggravation, inflammation, and obstruction of the bronchial tubes, which permit air all through the lungs. Most exacerbations are overseen in the outpatient setting. In the United States in 2004 there were 14.7 million visits to doctor workplaces and clinic outpatient divisions for acute asthma. In pediatric patients, a scoring rubric called the Pediatric Respiratory Assessment Measure (PRAM) has been created to evaluate a patient's acute asthma seriousness utilizing a mix of scalene muscle compression, suprasternal withdrawals, wheezing, air entry, and oxygen saturation. noninvasive ventilation has a few possible upper hands over intubation and intrusive mechanical ventilation: there are fewer requirements for sedation, the patient is allowed to talk, ventilation can be briefly suspended to permit the patient to take tastes of liquid or to cough and expectorate, and there is a lower hazard of ventilator-related pneumonia
 Aims and Objectives: The study intended to compared the efficiency of using oxygen inhalation and rapid-acting bronchodilator as first line management of acute exacerbant asthma.
 Materials and Methods: The study design is retrospective cross-sectional which was conducted during the period of 7 Months The study has considered 100 patients, among which 45 patients are male and 55 patients are female. The patients who visited the Emergency Department were considered. The patients on arrival to the emergency department was assessed for PRAM score (Initial PRAM score) and was interpreted. Then either oxygen or Short-Acting Beta Agonist (Salbutamol) inhalation was given. Then again, after a fixed interval, the patient’s PRAM score was assessed (Post-Interventional PRAM score). PRAM score was assessed and interpreted.
 Result: The study found that, after intervention, Group 1 achieved PRAM score of 4.48±1.41 in Group 1 (Oxygen group) while Group 2 (Short-Acting Beta Agonist inhalation) achieved 6.12±1.47. It was found that in patients of Group 1, the mean of changes in all the patients was 6 while in the patients of Group 2 was 4.18.
 Conclusion: The study concludes that the acute asthmatic episode in emergency department can be managed by oxygen inhalation better than Short-Acting Beta Agonist inhalation. Oxygen inhalation is easier to give as compared to intubation and is also efficient in lowering PRAM score and hence, evidently showed the efficacy for proper management of severe acute asthma in emergency setting.
 Keywords: pram, acute asthma, oxygen, salbutamol, non-ventilatory

Management of acute severe asthma and chronic obstructive pulmonary disease.

Management of acute severe asthma and chronic obstructive pulmonary disease.

Use of magnesium sulfate in continuous infusion in patients with severe acute asthma, in a pediatric emergency room.

Asthma is a chronic disease, of high prevalence, with important morbidity and that can lead to death in childhood. The use of intravenous magnesium sulfate has been indicated in cases refractory to the initial management with inhaled bronchodilators and corticosteroids. To evaluate the use of magnesium sulfate in continuous infusion (50 mg/kg/h in 4 h) in children with severe acute asthma in a pediatric emergency room. Ten-bed general pediatric emergency room, university hospital, tertiary, in southern Brazil. All children over 2 years old with severe acute asthma refractory to the initial treatment who received a continuous infusion of magnesium sulfate at a dose of 50 mg/kg/h in 4 h, from April 2017 to October 2019. Based on this study, the use of continuous intravenous magnesium sulfate proved to be well tolerated, leading to improved respiratory status, and can be considered as a satisfactory adjunctive therapy in the management of severe acute asthma.

Implementation of a Critical Care Asthma Pathway in the PICU.

Objectives:Acute asthma management has improved significantly across hospitals in the United States due to implementation of standardized care pathways. Management of severe acute asthma in ICUs is less well studied, and variations in management may delay escalation and/or deescalation of therapies and increase length of stay. In order to standardize the management of severe acute asthma in our PICU, a nurse- and respiratory therapist–driven critical care asthma pathway was designed, implemented, and tested.Design:Cross-sectional study of severe acute asthma at baseline followed by implementation of a critical care asthma pathway.Setting:Twenty-six–bed urban quaternary PICU within a children’s hospital.Patients:Patients 24 months to 18 years old admitted to the PICU in status asthmaticus. Patients with severe bacterial infections, chronic lung disease, heart disease, or immune disorders were excluded.Interventions:Implementation of a nurse- and respiratory therapist–driven respiratory scoring tool and critical care asthma pathway with explicit escalation/deescalation instructions.Measurements and Main Results:Primary outcome was PICU length of stay. Secondary outcomes were time to resolution of symptoms and hospital length of stay. Compliance approached 90% for respiratory score documentation and critical care asthma pathway adherence. Severity of illness at admission and clinical baseline characteristics were comparable in both groups. Pre intervention, the median ICU length of stay was 2 days (interquartile range, 1–3 d) with an overall hospital length of stay of 4 days (interquartile range, 3–6 d) (n = 74). After implementation of the critical care asthma pathway, the ICU length of stay was 1 day (interquartile range, 1–2 d) (p = 0.0013; n = 78) with an overall length of stay of 3 days (interquartile range, 2–3.75 d) (p < 0.001). The time to resolution of symptoms was reduced from a median of 66.5 hours in the preintervention group to 21 hours in the postintervention compliant group (p = 0.036).Conclusions:The use of a structured critical care asthma pathway, driven by an ICU nurse and respiratory therapist, is associated with faster resolution of symptoms, decreased ICU, and overall hospital lengths of stay in children admitted to an ICU for severe acute asthma.

Methylprednisolone, dexamethasone or hydrocortisone for acute severe pediatric asthma: does it matter?

Objective Various intravenous (IV) corticosteroids are available for acute severe asthma (ASA) treatment. The choice of IV corticosteroids varies broadly and depends on institution, country, or physician preferences. In this study, we compared the efficacy of IV methylprednisolone, hydrocortisone and dexamethasone in ASA treatment during pediatric intensive care unit (PICU) admission. Methods The study was a prospective randomized clinical trial. We enrolled patients of 1–21 years after they were admitted to the PICU requiring continuous beta-2 agonist treatment. Patients were randomized into three groups: Group A: IV Methylprednisolone, Group B: IV Hydrocortisone and Group C: IV Dexamethasone. The primary outcomes measured were durations of beta-2 agonist continuous nebulization treatment. Secondary outcomes, included PICU and hospital length of stay (LOS), pediatric asthma severity score (PASS), need for mechanical ventilation and maximum dose of beta-2 agonist treatment. Results 61 patients were included in the analysis. 22 patients recruited in Group A, 20 in group B and 19 group C. Median durations of beta-2-agonist treatment were 23 h (QR 16–38) for methylprednisolone, 27 h (QR 16–40) for hydrocortisone, and 32 h (QR 16–48) for dexamethasone (p = 0.90). There was no difference in PICU LOS, hospital LOS, PASS score, B2 agonist maximum dose, or need for ventilation support. Conclusions The use of IV methylprednisolone, hydrocortisone, and dexamethasone have equivalent efficacy when used at the appropriate doses. Studies with larger cohorts are needed to compare the effectiveness of IV corticosteroids in the management of ASA in the PICU setting.

Severity Factors and Management of Severe Acute Asthma in Saint Louis, Senegal: About 20 Cases

The Journal of Anesthesia & Intensive Care Medicine (JAICM) is a globally accepted journal that aims to publish innovative scientific developments and high quality information on anesthesia and intensive care medicine.

Is ketamine a lifesaving agent in childhood acute severe asthma?

Children with acute severe asthma exacerbation are at risk of developing respiratory failure. Moreover, conventional aggressive management might be futile in acute severe asthma requiring intubation and invasive ventilation. The aim of this review is to detail evidence on the use of ketamine in childhood asthma exacerbations. A search of the MEDLINE, EMBASE, and Cochrane databases was performed, using different combinations of the following terms: ketamine, asthma, use, exacerbation, and childhood. In addition, we searched the references of the identified articles for additional articles. We then reviewed titles and included studies that were relevant to the topic of interest. Finally, the search was limited to studies published in English and Spanish from 1918 to June 2015. Due to the scarcity in the literature, we included all published articles. The literature reports conflicting results of ketamine use for acute severe asthma in children. Taking into consideration the relatively good safety profile of the drug, ketamine might be a reasonable option in the management of acute severe asthma in children who fail to respond to standard therapy. Furthermore, pediatricians and pediatric emergency clinicians administering ketamine should be knowledgeable about the unique actions of this drug and its potential side effects.

ABSTRACT 397

Background and aims: The BTS asthma guideline has been available since 2008. The North West and North Wales Paediatric Transport Team (NWTS) introduced a guideline for the management of acute severe asthma in February 2013. This has since been available on the NWTS website and has been part of ongoing outreach education. Aims: To assess the impact of NWTS asthma guideline. Methods: Retrospective audit of NWTS database for ‘asthma’ patients and case note review with limited electronic access to PICU letters and case summaries for these patients. Previous audit data was used for comparison. Results: 36 Patients were identified out of 888 referrals (4%). 18 were managed locally, 6 transferred to HDU and 12 to PICU. 12 patients accounted for a total of 46 PICU bed days. 20% of all lactate measurements recorded were > 4 mmol/l.Table: No title available.Conclusions: Data so far support the notion that introduction of the guideline has optimised pre-intubation bronchodilator therapy in these patients and also contributed to lesser morbidity, with more patients avoiding intubation and/or transfer to regional PICU. There were no peri-intubation air leaks or deaths in this patient group. We also feel that this guideline has encouraged earlier referral, supported by the reduction in number of patients intubated at time of referral. Significant lactic acidaemia was noted in subgroup of patients which is likely to be related to bronchodilator therapy. Further data gathering is in progress to ascertain if the raised lactate values influence the decision to administer fluid boluses to these patients.

Intravenous or nebulised magnesium sulphate versus standard therapy for severe acute asthma (3Mg trial): a double-blind, randomised controlled trial

Previous studies suggested intravenous or nebulised magnesium sulphate (MgSO(4)) might improve respiratory function in patients with acute asthma. We aimed to determine whether intravenous or nebulised MgSO(4) improve symptoms of breathlessness and reduce the need for hospital admission in adults with severe acute asthma. In our double-blind, placebo-controlled trial, we enrolled adults (aged ≥16 years) with severe acute asthma at emergency departments of 34 hospitals in the UK. We excluded patients with life-threatening features or contraindication to study drugs. We used a central randomisation system to allocate participants to intravenous MgSO(4) (2 g in 20 min) or nebulised MgSO(4) (three 500 mg doses in 1 h) alongside standard therapy including salbutamol, or placebo control plus standard therapy alone. We assessed two primary outcome measures in all eligible participants who started treatment, according to assigned treatment group: the proportion of patients admitted to hospital within 7 days and breathlessness measured on a 100 mm visual analogue scale (VAS) in the 2 h after initiation of treatment. We adjusted for multiple testing using Simes's method. The trial stopped before recruitment was completed because funding expired. This study is registered, number ISRCTN04417063. Between July 30, 2008, and June 30, 2012, we recruited 1109 (92%) of 1200 patients proposed by the power calculation. 261 (79%) of 332 patients allocated nebulised MgSO(4) were admitted to hospital before 7 days, as were 285 (72%) of 394 patients allocated intravenous MgSO(4) and 281 (78%) of 358 controls. Breathlessness was assessed in 296 (89%) patients allocated nebulised MgSO(4), 357 (91%) patients allocated intravenous MgSO(4), and 323 (90%) controls. Rates of hospital admission did not differ between patients treated with either form of MgSO(4) compared with controls or between those treated with nebulised MgSO(4) and intravenous MgSO(4). Change in VAS breathlessness did not differ between active treatments and control, but change in VAS was greater for patients in the intravenous MgSO(4) group than it was in the nebulised MgSO(4) group (5·1 mm, 0·8 to 9·4; p=0·019). Intravenous or nebulised MgSO(4) did not significantly decrease rates of hospital admission and breathlessness compared with placebo: intravenous MgSO(4) was associated with an odds ratio of 0·73 (95% CI 0·51 to 1·04; p=0·083) for hospital admission and a change in VAS breathlessness of 2·6 mm (-1·6 to 6·8; p=0·231) compared with placebo; nebulised MgSO(4) was associated with an odds ratio of 0·96 (0·65 to 1·40; p=0·819) for hospital admission and a change in VAS breathlessness of -2·6 mm (-7·0 to 1·8; p=0·253) compared with placebo. Our findings suggest nebulised MgSO(4) has no role in the management of severe acute asthma in adults and at best suggest only a limited role for intravenous MgSO(4) in this setting. UK National Institute for Health Research Health Technology Assessment Programme.

Pharmacological management of acute asthma exacerbations in adults

Acute exacerbations of asthma can be life threatening. This article provides an overview of the pathophysiology, diagnosis and management of acute severe asthma in adults. An understanding of the signs and symptoms of the disorder, and treatment options will ensure rapid decision making when time is crucial during an exacerbation. A proactive approach to managing acute severe asthma may substantially improve patient outcomes and reduce the need for readmission to hospital.

Ketamine for management of acute exacerbations of asthma in children.

Asthma is the most common chronic disease in children, and children with asthma frequently visit the paediatric emergency departments with acute exacerbations. Some of these children fail to respond to standard therapy (aerosol beta(2)-agonist with or without aerosol anticholinergic and oral or parenteral corticosteroids) for acute asthma leading to prolonged emergency department stay, hospitalisation, morbidity (e.g. barotrauma, intubation) and death, albeit rarely. Ketamine may relieve bronchospasm and is a potentially promising therapy for children with acute asthma who fail to respond to standard treatment. To evaluate the efficacy of ketamine compared to placebo, no intervention or standard care for management of severe acute asthma in children who had not responded to standard therapy. We identified trials from the Cochrane Airways Group Specialised Register of trials (CAGR) and ClinicalTrials.gov. We reviewed reference lists of all primary studies and review articles for additional references. We contacted authors of identified trials and asked them to identify other published and unpublished studies. The latest search was in July 2012. Randomised controlled trials comparing ketamine to placebo or standard care in children (up to 18 years of age) presenting with an acute asthma exacerbation who had not responded to standard therapy. Two review authors independently selected studies. The data were extracted in pre-defined proforma and were analysed independently by two review authors. The data analysis was performed using Review Manager 5.1. A single study enrolling 68 non-intubated children was found eligible for inclusion in review. The study had low or unclear risk of bias. It demonstrated no significant difference in respiratory rate, oxygen saturation, hospital admission rate (odds ratio (OR) 0.77; 95% confidence interval (CI) 0.23 to 2.58) and need for mechanical ventilation between ketamine (0.2 mg/kg intravenous bolus over one to two minutes, followed by a 0.5 mg/kg per hour continuous infusion for two hours) and placebo group. There were no significant side effects of ketamine in the study. There was also no difference in need for other adjuvant therapy (OR 2.19; 95% CI 0.19 to 25.40) and in Pulmonary Index Score (mean difference (MD) -0.40; 95% CI -1.21 to 0.41) between the groups. The single study on non-intubated children with severe acute asthma did not show significant benefit and does not support the case studies and observational reports showingbenefits of ketamine in both non-ventilated and ventilated children. There were no significant side effects of ketamine. We could not find any trials on ventilated children. To prove that ketamine is an effective treatment for acute asthma in children, there is need for sufficiently powered randomised trials of high methodological quality with objective outcome measures of clinical importance. Future trials should also explore different doses of ketamine and its role in children needing ventilation because of severe acute asthma.

Eficacia del sulfato de magnesio como tratamiento inicial del asma aguda grave pediátrica. Estudio aleatorizado y controlado

Magnesium sulfate is a calcium antagonist that inhibits bronchial smooth muscle contraction promoting bronchodilation. It is used for the management of acute severe asthma in children; however most of the studies have been performed in adults. To evaluate the effectiveness of intravenous magnesium sulfate for the treatment of pediatric patients with acute severe asthma exacerbations. A clinical, randomized, controlled trial was conducted between March 2006 and March 2011 at Hospital Universitario Austral. Children with acute severe asthma admitted to the emergency department were randomized into two groups. Group A (control group): standard protocol for the initial treatment of acute asthma exacerbation. Group B: treatment protocol with magnesium sulphate for acute severe asthma exacerbation. The primary outcome was the requirement of invasive or non invasive mechanical ventilation support. One hundred and forty three patients randomized into 2 groups were analyzed. The treatment group included 76 patients receiving magnesium sulfate within the first hour of the initiation of rescue treatment at the hospital, and the control group included 67 patients not treated with magnesium sulphate. Among the patients in the control group, 33% (n= 22) required mechanical ventilation support, compared to only 5% (n= 4) of the patients in the treatment group (p = 0.001). Intravenous infusion of magnesium sulfate during the first hour of hospitalization in patients with acute severe asthma significantly reduced the percentage of children who required mechanical ventilation support.

Management of acute severe asthma in children age over 1 year

Introduction 15% of UK children have asthma and some (23 in 2002) still die during an acute exacerbation. There is evidence that some patients are not on optimum treatment and aggressive care can improve outcome. To improve management in our department a wheezy child care pathway was introduced which included a flow chart for management of acute severe asthma. Objectives To compare the management of patients with acute severe asthma admitted to HDU against revised British Thoracic Society Guidelines 2009 and identify areas for improvement. Methods Retrospective analysis of all patients admitted to HDU with acute wheeze over a period of 18 months. Results Total of 78 admissions, notes obtained for 45 admissions in 38 patients. Mean age was 60 months with a male preponderance. 54% were known asthmatics and 20% had previous HDU admission. All were treated with nebulised salbutamol, ipratropium bromide and oral/intravenous (IV) steroids in proper dose. 58% needed IV salbutamol and 15% were not given bolus dose. 44% developed hypokalemia and 97% developed hyperglycaemia on IV salbutamol. 60% were not seen by asthma nurse during admission. No proper documentation of whether written information was given or regular treatment was reviewed before discharge. Conclusion Audit identified areas for improvement and measures have been introduced to bring about change which included memo to staff about bolus dose of IV salbutamol and kit to make up IV salbutamol infusion (which includes 200 ml bag of 0.9% saline with 8 mmol KCl) to reduce hypokalemia and hyperglycaemia.

P109 Intravenous aminophylline in the treatment of severe asthma: do we need ECG monitoring?

IntroductionIntravenous (IV) aminophylline has an established role in the management of acute severe asthma, with beneficial bronchodilatory, anti-inflammatory and immunomodulatory effects. However, concern is often raised regarding its potential to...

Management of severe acute asthma in the emergency department

Asthma is one of the most common chronic diseases in most developed countries and control may be elusive. Deterioration in asthma control is common when patients are exposed to airway irritants, viruses, and/or when adherence to chronic anti-inflammatory medications is suboptimal. Acute asthma exacerbations are common, important reasons for presentations to emergency departments, and severe cases may result in hospitalization. Important knowledge gaps exist in what is known and what care is delivered at the bedside. The literature in asthma is rapidly expanding and recent advances in the care are important to summarize. Systematic reviews, especially high-quality syntheses performed using Cochrane methods, provide the best evidence for busy clinicians to remain current. Management of asthma is based on early recognition of severe disease with aggressive therapy using multimodal interventions that focus on both bronchoconstriction and inflammatory mechanisms. Treatment of severe acute asthma can effectively and safely reduce hospitalizations, airway interventions, and even death. Using the approach outlined herein will enable clinicians to assist patients to rapidly regain asthma control, return to normal activities, and improve their quality of life in the follow-up period.

S68 Evaluation of non-invasive ventilation in management of acute severe asthma

ObjectivesTo study the role of non-invasive positive pressure ventilation (NIPPV) in management of acute severe asthma.Study designOpen randomised controlled trial.Methods50 patients of acute severe asthma having asthma for at least...

Asthma care pathways in the emergency department

The purpose of this review is to describe recent evidence of the efficacy and effectiveness of clinical pathways for the assessment and management of severe acute asthma in children and adults in the emergency department (ED). The review will highlight examples of successful knowledge translation initiatives and their ability to support adherence to Best Practice Guidelines. Recent studies reveal that management of pediatric and adult asthma in the ED setting often differs from that which is recommended in clinical practice guidelines. Single and multicenter North American studies have consistently found care gaps. Barriers to adherence to evidence-based management guidelines are numerous. Care pathways are knowledge translation tools that provide a means of applying knowledge translation principles to overcome these barriers, integrate guidelines into practice and optimize patient outcomes. Evidence from a recent Ontario multicenter asthma clinical pathway initiative is highlighted, demonstrating increased adherence to certain aspects of ED care, improved patient recollection of teaching done in the ED and increased referral rates. These findings strengthen the evidence supporting the development and implementation of standardized evidence-based asthma clinical pathways. Gaps between current and best practices persist for the management of asthma in children and adults in North American EDs. There is robust evidence in support of ED asthma clinical pathways to optimize asthma care and outcomes in this setting.

Clinical Audit: Management of Acute Severe Asthma in West Glasgow

The U.K. has 75,000 hospital admissions and over 1500 deaths from asthma annually. The British Thoracic Society (BTS) guidelines represent the recognised standard for acute asthma management. We assessed the degree of conformity with these guidelines in an acute medical unit. Data from consecutive admissions were collected prospectively. Practice was audited in October December 2005 and October 2006 - January 2007. Between cycles an educational programme was instigated, Fifty-eight patients were included. Clinical parameters were well recorded in both cycles. Peak expiratory flow was consistently under-recorded (72% at admission; 67% in monitoring). in monitoring). Severity assessment was documented at 55% and 66% in cycle one and two respectively. Of these, the assessment was incorrect in 33% in cycle one and 21% in cycle two. All misclassifications of severity were underestimates. All life-threatening attacks were not identified. No improvement occurred between cycles. Overall, 60% of patients were inappropriately treated according to BTS guidelines, 40% due to under-treatment. Under-treatment occurred more frequently in cycle two compared with cycle one (57% vs. 24%, p = 0.007), predominantly due to inadequate treatment of life-threatening asthma. Management of acute asthma in a large, urban teaching hospital is suboptimal. Educational intervention failed to improve care; more comprehensive strategies are required.

IMPACT OF ASTHMA EDUCATION ON KNOWLEDGE OF MANAGEMENT OF ACUTE SEVERE ASTHMA AMONGST PRACTICING NURSES IN OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITAL COMPLEX ILE-IFE NIGERIA

PURPOSE: The upsurge in the incidence of acute severe asthma in the face of slow institutional response to the management of asthma, has heightened public concern in Nigeria. It is against this background that this study investigated the impact of asthma education on knowledge of management of acute severe asthma amongst practicing nurses vis-α-vis signs and symptoms of the disease as well as its therapy.