Guidelines and pathways

This section is intended for clinicians caring for children with asthma in primary care, community care, hospital or tertiary care setting. It outlines best practice examples of guidelines and pathways. Innovative whole pathways of care, including specialist outreach, and moving care closer to home to deliver all required services, are key to integrating care.


London Asthma Leadership and Implementation Group for CYP (LALIG) statements:

  • PAAPs: LALIG has produced a suite of Personalised Asthma Action Plans (PAAPs) for use across London. These have drop down boxes so clinicians completing them can include the medication used and indicate the colour of the inhaler. In addition there is a logic function around the peak flow highlighting when individual levels are too low and what action should be taken, in conjunction with symptoms. PAAP 4-11 in colourPAAP 4-11 in black & white (for printing if needed)PAAP 12-18 in colourPAAP 12-18 in black & white. MART (Maintenance and Reliever Therapy) and AIR (anti-inflammatory reliever) PAAPs will be added when available.

  • Salbutamol: The use of salbutamol weaning plans after an acute asthma attack is not recommended. Evidence suggests that higher use of short-acting beta-agonists (SABA) is associated with adverse clinical outcomes.  Standardised prescriptive salbutamol weaning plans may mask deterioration in asthma control, which could be life threatening. 
  • Oximetry: There is evidence that pulse oximetry in people with brown or black skin tones may underestimate the level of hypoxia; the oximeter companies are aware of this and working on possible solutions. Therefore, clinicians should not rely on oximetry alone and assessments of people with asthma should include a thorough assessment including respiratory and pulse rate and lung function. Please find a statement on the use of oximetry for people with brown or black skin tones which has been agreed for London.
  • The use of peak expiratory flow in personalised asthma action plans

National guidelines


Guidelines from London ICSs