Asthma (acute exacerbation)

What is an acute exacerbation of asthma? A worsening of your child’s asthma caused by exposure to one of their triggers. These vary between children but the most common ones are coughs and colds, cold weather, cigarette smoke, pet fur or feathers and pollen.

Acute exacerbation of asthma

Thumbnail Acute Exacerbation of Asthma.png

QR code to Acute exacerbation of asthma page

Parent/carer page

Child's Asthma getting worse | Healthier Together (nenc-healthiertogether.nhs.uk)

Acute asthma management

Please see our link to Beat Asthma for tips on diagnosis, resources for families and your online asthma action plans 

Asthma Diagnosis - Beat Asthma 

  • Is this asthma, making a diagnosis and red flags

  • standard technique for use inhalers

  • Personal asthma plan proforma

Also see Beat Asthma video Beat Asthma - How to use an aerochamber spacer with mask - YouTube

Chronic asthma management 

Chronic management - Beat Asthma

  • National asthma Guidelines

  • Personal asthma plans

  • Asthma annual review proforma

  • Indications for referral to secondary care asthma services

If your child has any of the following:

  • Too breathless to talk / eat or drink
  • Has blue lips
  • Having symptoms of cough/wheeze or breathlessness which are getting worse despite 10 puffs blue (salbutamol) inhaler every 4 hours
  • Breathing very fast or breathing that stops or pauses
  • Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
  • Becomes pale, blue, mottled and/or unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched, continuous cry or extremely agitated
  • Has a fit (seizure)
  • A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months
  • Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')

You need urgent help.

Go to the nearest Hospital Emergency (A&E) Department or phone 999

If your child has any of the following:

  • Blue (salbutamol) inhaler 2-5 puffs via a spacer is not lasting 4 hours
  • Cough or wheeze/tight chest during the day and night
  • Too breathless to run/play/do normal activities
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips, tongue or looking pale
  • Not had a wee or wet nappy in last 12 hours
  • Sleepy or not responding normally
  • Crying and unsettled
  • Not drinking
  • A temperature 39oC or above in babies 3-6 months
  • Temperature of 38oC or above for more than 5 days or shivering with fever (rigors)
  • Getting worse or you are worried about them

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If your child has none of the above:

Watch them closely for any change and look out for any red or amber symptoms

Self care

Continue providing your child’s care at home. If you are still concerned about your child, call NHS 111 – dial 111

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.