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
- Nebuliser: This case study from Barking Havering and Redbridge describes a near miss involving the use of a home nebuliser. The following letter was sent out by LALIG in response, warning that nebulisers and salbutamol nebules should only be prescribed for the treatment of asthma by secondary or tertiary care. The MHRA have produced guidance on this together with videos for health care professionals and families.
- 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
- British guideline on the management of asthma SIGN
- Clinical assessment of acute asthma for a child aged 2-16 years in acute setting
- NICE guidelines on management of asthma in children and young people
- Clinical assessment of acute asthma for a child aged 2-16 years in a community setting
- National Paediatric Asthma Collaborative Secondary care guideline over National Paediatric Asthma Collaborative Secondary care guideline under Management of acute exacerbation of asthma / wheeze primary care clinical assessment tool for children under two years (NHS England
- Management of acute exacerbation of asthma / wheeze primary care clinical assessment tool for children over two years (NHS England)
Guidelines from London ICSs
- Islington CCG Acute Wheezy Episode 2-5 years
- Acute asthma attack management for 5-18 year olds – Islington CCG
- Asthma in children and young people (preschool to 17 years) A guide for SEL general practice
- Clinical management of acute exacerbations of asthma and wheeze (part 1) – London North West Healthcare Trust
- Clinical management of acute exacerbations of asthma and wheeze (part 2) – London North West Healthcare Trust
- Clinical management of acute exacerbations of asthma and wheeze (part 3) – London North West Healthcare Trust
- South East Coast SCN Children and Young People’s service Acute Asthma / Wheeze Pathway
- Moderate Paediatric Asthma Attack Pathway – for use in children 5 yrs and over
- London’s integrated urgent care Clinical Assessment Service (CAS) have developed a Mild Paediatric Asthma Pathway for use in children aged 5 – 16 years old (GP only)