Diagnosis Asthma is a clinical diagnosis. The assessment presented has been kept as simple as possible but does not constitute a compromise as it conforms to international assessment criteria. A severity grading is important to place the child into a particular treatment category. The assessment of severity refers to a child with regular or intermittent symptoms. The assessment and management of the acute attack is dealt with in a previous guideline .
Asthma presents as a spectrum of severity rather than in discrete severity groups.
Practitioners should attempt to accurately grade each patient but must regard this only as a starting point. Asthma can vary with time. PEFR should not be used to classify patients during acute attacks. Parents and patients should be taught that failure to respond to two doses of inhaled bronchodilator given 30 minutes apart constitutes a severe attack of asthma. This should not be managed at home without medical supervision.