management of acute severe asthma in adults

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Guidelines for the management of acute severe asthma have been developed based on an initiative by the British Thoracic Society (BTS) in 1997. They have now been updated by the BTS in conjunction with the Scottish Intercollegiate Guidelines Network and the revised edition was published in July 2019.

The guidelines provide a framework within which most patients with asthma can be managed.

Health care professionals must be aware that patients with severe asthma and one or more adverse psychosocial factors are at risk of death

  • keep patients who have had near fatal asthma or brittle asthma under specialist supervision indefinitely
  • a respiratory specialist should follow up patients admitted with severe asthma for at least one year after the admission


  • (1) British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) 2019. British Guideline on the Management of Asthma. A national clinical guideline.

Last edited 11/2019 and last reviewed 11/2019