Last reviewed
2026-02-07
Workflow pack
Wheeze/asthma exacerbation workflow
Primary care wheeze workflow for rapid severity framing, escalation triggers, and controller-plan reinforcement.
Trust and governance
Use only within this workflow's defined scope and exclusions.
Clinical owner
Family Medicine Editorial Team
Risk tier
High
Review cadence
Every 3 months
Next due 2026-05-07
Review status
Current
Scope limits
Outpatient initial management of wheeze/asthma symptoms in patients without immediate respiratory failure signs.
Exclusions (escalate/redirect)
- Severe respiratory distress, hypoxia, or exhaustion requiring emergency pathway.
- Inpatient-level acute asthma management.
References
Escalate-now emphasis (high-risk workflow)
If any red-flag item is present, stop routine workflow steps and activate emergency escalation immediately.
At a glance
Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.
Immediate actions
- Assess breathing effort, oxygenation, and speech tolerance immediately.
- Confirm reliever use response and current exacerbation trajectory.
- Identify high-risk comorbidity or prior severe exacerbation history.
Red flags / escalate now
- Hypoxia, silent chest, exhaustion, or altered level of consciousness.
- Poor response to initial reliever pathway with persistent respiratory distress.
- Any rapid deterioration in airway/breathing status.
First-line plan
- Start rapid reliever management and repeat objective reassessment.
- Address inhaler technique and adherence barriers in-visit.
- Define controller-plan and escalation boundaries before discharge.
Follow-up and monitoring
- Arrange short-interval reassessment after acute symptom visit.
- Escalate to urgent/emergency care for incomplete response or relapse.
- Reinforce action plan and return precautions in plain language.
Next useful actions
Keep moving without restarting the search.
These are the most likely next clicks after opening this workflow.
Condition guidance
Prescribing aids
Referral checklists
Tools and calculators
Patient handouts
Return precautions (patient script)
Suggested plain-language wording for safety-net counseling:
If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.
- Use with the specific red flags listed on this page.
- Confirm follow-up timing and where to go after-hours.
- Document that return precautions were reviewed and understood.
Visit-close checklist
- Document disposition, rationale, and unresolved diagnostic uncertainty.
- Give explicit return precautions and follow-up timeline before ending visit.
- Attach a relevant handout when available to reinforce adherence and safety-netting.