Asthma Attack Assessment

ABCs and Vitals


  • Speech
  • Posture
  • Work of breathing (accessory muscles, RR and depth, HR and rhythm, diaphoresis, level of comfort, level of consciousness)
  • Signs of obstruction or impending respiratory exhaustion/failure
    • Tracheal tug (downward descent of trachea with inspiration)
    • Decreasing LOC
    • Irregular or decreasing amplitude of pulse
    • Pulsus paradoxus (measure BP)
    • Respiratory alternans, or paradoxical movement of diaphragm
    • Cyanosis (central – late and ominous finding, peripheral)


  • Signs of bronchospam
    • Wheeze
    • Prolongation of expiratory phase
    • Quiet chest = BAD
  • Exacerbation factors
    • Evidence of upper and lower respiratory tract infections
    • Pneumothorax
    • Allergies
  • Measure peak flow and/or spirometry

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