Monitoring treatment

The efficacy of asthma treatment should be monitored:

• measure and record PEF 15-30 minutes after starting treatment, and thereafter according to the response
• measure and record PEF before and after nebulised or inhaled beta 2 agonist bronchodilator (at least four times daily) throughout the hospital stay and until controlled after discharge
• record oxygen saturation by oximetry and maintain arterial SpO2 at 94–98%.
• repeat measurements of blood gas tensions within one hour of starting treatment if:
  • the initial PaO2 is <8 kPa unless SaO2 is >92%;
  • or the initial PaCO2 is normal or raised;
  • or the patient’s condition deteriorates
• measure them again if the patient’s condition has not improved by 4-6 hours
• measure and record the heart rate
• measure serum potassium and blood glucose concentrations
• measure the serum theophylline concentration if aminophylline is continued for more than 24 hours (aim at a concentration of 10–20 mg/l or 55-110 mcg/mol/l).

Reference:

• (1) British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) 2016. British Guideline on the Management of Asthma. A national clinical guideline