Acute Severe Asthma Management

1 What is the Acute Severe Asthma Management?

Acute Severe Asthma Management is an in-app clinical reference guide for status asthmaticus in children, covering the first-line drug trio and escalation therapies. It organizes treatment into three core medication classes — β2 agonists, anticholinergic agents, and corticosteroids — plus a set of escalation medications for refractory cases. The guide also includes clinical pearls on severity assessment, IV magnesium as a preferred first escalation step, and indications for intubation. Per the source, the research-based context in these pearls draws on the GINA 2023 Global Strategy for Asthma Management, the BTS/SIGN British Asthma Guideline 2019, and AAP Section on Pulmonology consensus.

2 When to use it

Guiding first-line drug selection (β2 agonist, anticholinergic, corticosteroid) for a child in acute severe asthma / status asthmaticus
Assessing severity using criteria such as ability to speak, respiratory rate, heart rate, oxygen saturation, and peak flow
Selecting an escalation agent when first-line therapy is insufficient
Deciding when a child in status asthmaticus needs intubation and planning a rapid sequence induction approach
Reviewing dosing and administration notes for each medication class at the bedside

3 Formula & method

The guide presents medications grouped into three core classes — β2 agonist, anticholinergic agents, and corticosteroids — each with its own dosing and frequency notes, followed by an "Other medications" escalation section (magnesium, theophylline, ketamine, vecuronium). It is a structured reference rather than a calculator: there is no computed score, only a fixed set of medication and severity-assessment information transcribed from the source guide, supplemented with labelled "research add-on" clinical pearls.

GINA 2023
BTS/SIGN British Asthma Guideline 2019
AAP Section on Pulmonology consensus

4 Frequently asked questions

What three drug classes make up first-line therapy in this guide?

β2 agonists, anticholinergic agents, and corticosteroids, presented under the guide's "Medications" section.

What escalation medications are listed for refractory status asthmaticus?

Magnesium, theophylline, ketamine, and vecuronium are listed under "Other medications."

What severity criteria does the guide reference?

A GINA 2023-sourced pearl lists criteria including inability to speak in full sentences, respiratory rate over 30/min with accessory muscle use, heart rate over 120/min, SpO2 under 90% on room air, and PEF at or below 50% of predicted/personal best.

What is the guide's preferred escalation step after standard therapy fails?

A clinical pearl in the guide identifies IV magnesium as the preferred escalation after about one hour of standard therapy without improvement.

What guidelines inform the research add-on pearls in this guide?

The source cites the GINA Global Strategy for Asthma Management 2023, the BTS/SIGN British Asthma Guideline 2019, and AAP Section on Pulmonology consensus.

5 Related tools

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.