Information about how to identify and diagnose asthma and the tests expected.

Asthma exacerbations can be classified as mild, moderate, severe, or life threatening. In the ambulatory, urgent care and emergency department settings, the treatment goals are correction of severe hypoxemia, rapid reversal of airflow obstruction and preventing relapse.

A useful quick reference guide to diagnosis and management: British guideline on the management of asthma.

There is a need to improve asthma identification and access to treatment to improve quality of life for patients. Diagnosis is difficult as there is no single diagnostic test, but it should be in line with BTS/Sign guidelines.

Spirometry is recommended for adults, but may be less useful in children. New NICE guidance suggests its use and also consideration of Fractional exhaled Nitric oxide (FeNO). The primary care workforce will be unskilled in a similar way to training for spirometry for COPD. Commissioners will need to consider ways to ensure there is quality assurance of any future services.

Here are some FAQs regarding the National Register for Spirometry.

Which diagnostic tests are expected?

It will be important for commissioners to ensure that their local services include the following:

Detailed relevant family and personal medical history recorded in notes:

Ensure clinicians have a good understanding of best practice and consider regular audits of practice using British Asthma/ SIGN guideline London asthma standard for children and young people and NICE Quality Standards – Asthma quality standard [QS25] and have received training in asthma diagnosis and management.

Objective measurement of lung function is important in the diagnosis and assessment of acute and chronic asthma. This guide on peak flow measurement will provide support to clinicians.

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