Podcast - When breathing fails: Hard lessons from asthma deaths

The video version of this podcast can be found here: · https://youtu.be/JP5EvxGd8g4This channel may make reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido (also known as Juan Fernando Florido Santana), a GP in the UK. In this episode, I will go through the new NICE guideline on acute asthma, NG244, focusing on what is relevant in Primary Care only. Given how extensive the guidance is, in this episode I will just focus on lessons from asthma deaths and near-fatal asthma as well as reviewing the concept of difficult asthma. In the last four episodes I covered the initial assessment and treatment in both adults and children. Just like the NICE guideline on the management of chronic asthma, which was updated in November 2024, the NICE guideline on acute asthma is also a collaborative initiative developed by NICE, the British Thoracic Society (BTS), and the Scottish Intercollegiate Guidelines Network (SIGN). It replaces previous guidance, and you can find a link to it in the episode description.I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] Music provided by Audio Library Plus Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The link to the new NICE guideline on acute asthma can be found here:· https://www.nice.org.uk/guidance/ng244/chapter/Managing-acute-asthmaBased on recommendations on managing acute asthma in the BTS/SIGN British guideline on the management of asthma:· https://rightdecisions.scot.nhs.uk/bts-nice-and-sign-asthma-pathway/managing-acute-asthma/Disclaimer:The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions. In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido.TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the new NICE guideline on acute asthma, or NG244, focusing on what is relevant in Primary Care only. Just like in chronic asthma, the NICE guideline on acute asthma is a joint effort by NICE, BTS and SIGN and a link to it is in the episode description.In this episode I will just focus on lessons from asthma deaths and the concept of difficult asthma. In the last four episodes I covered the initial assessment and treatment in both adults and children and, if you have not already, I recommend that you check them out.Right, let’s jump into it.Confidential inquiries into over 200 asthma deaths in the UK have identified that most asthma deaths occurred before the patient reached hospital and that there are three main contributing factors: the disease itself, medical management, and patient behaviour or psychosocial issues..And let’s start by looking at Disease Factors: Although, In a minority the fatal attack occurred suddenly in a patient with mild or moderately severe asthma, the majority of patients who died from asthma had chronically severe disease. In terms of Medical Management: Many deaths were linked to inadequate treatment with inhaled corticosteroids (ICS) or oral steroids, as well as poor monitoring of asthma severity. Follow-up ...