Conditions
Wheeze and asthma symptom triage
Structured approach to acute wheeze in primary care with escalation rules for respiratory compromise.
Last reviewed 2026-02-07|asthma | wheeze | respiratory
Assessment priorities
- Assess respiratory distress severity, oxygenation, and speech tolerance immediately.
- Confirm trigger pattern, reliever use frequency, and recent exacerbation history.
- Review adherence to controller therapy and inhaler technique.
Red flags
- Silent chest, severe hypoxia, exhaustion, or altered level of consciousness.
- Persistent respiratory distress despite reliever therapy.
- High-risk comorbidity or inability to ensure safe home monitoring.
Initial management
- Initiate rapid reliever pathway and objective reassessment after initial treatment.
- Address inhaler technique and adherence gaps contributing to instability.
- Define escalation threshold early when response is incomplete.
Follow-up and escalation
- Reassess shortly after acute visit and confirm symptom trajectory.
- Escalate to urgent/emergency care if worsening or poor response continues.
- Reinforce written action plan and return precautions.