5, 4, 3, 2, 1, fire!

Welcome to the Recess Room podcast.

Hi, I'm Simon Lang and welcome back to the Recess Room podcast.

Sadly, Rob Fenwick's not able to join this tonight,

but don't worry, he'll be back as normal next time. So just when you've had a chance to get

used to the new sepsis guidelines, all your practice is settling down. Along comes a new guideline. So this week, the new BTS guidelines for asthma

came out and there are some changes that directly affect our practice in emergency care. So in

this really short episode, I'm just going to highlight the main changes that affect emergency care.

The document, as you would

expect is pretty expansive and deserves a read when you get time. But until then, hopefully

this will act as a good overview for the things that you need to look out for. But a small

sigh of relief, there aren't a massive number of changes to this guideline. You're not

being asked to completely

re-evaluate and change the way that you risk stratifying asthma, treating it and then managing

it. So the first thing to say is that there seems to be, quite appropriately, a big focus on

those patients who are at high risk of near-fatal or fatal asthma.

Now if you ask most people to list a risk factor, they'll probably say a previous ITU admission

with asthma. But actually there's loads more to it and they list that in the document.

And it actually highlights that what are really difficult patients are

actually really high risk. So those patients are potentially more complex with drug or alcohol

abuse. That could be more complicated to evaluate with learning difficulties. The patients with social

isolation, people with severe domestic marital or legal stress, those who have fewer GP contacts and

...