Taking a history

When taking a history from a child and their parent or carer with suspected asthma, it’s important to check for acute and chronic symptoms, the triggers that make the symptoms worse, any family history of asthma or allergies, and the treatment that worked when they were unwell.

 

Episodic symptoms

More than one of the symptoms of wheeze, cough, breathlessness, chest tightness and exercise symptoms. Periods with minimal symptoms between episodes

 

Recurrent episodic wheeze

  • Clarify what a child/carer actually means by wheeze
  • Clarify if wheeze ever confirmed by a healthcare practitioner and treated as wheeze
  • Worse at night and with exercise

 

Recurrent episodic dry cough

  • Worse at night and with exercise
  • Cough without wheeze – asthma unlikely
  • Wet cough not usually a sign of asthma

 

Diurnal variation

  • Symptoms worse at night and in the early morning
  • Symptoms responsive to salbutamol in past

 

Triggers and irritants

  • Triggers: Viral infection and aeroallergens (house dust mite, pollen, grass, pets)
  • Irritants: Symptoms exacerbated by cold air, second-hand smoke perfume, emotion and laugher

 

Atopic history: Eczema, allergic rhinitis

  • Atopy preferably supported by positive skin prick test or specific IgE levels to aeroallergens or raised blood eosinophilia

 

Family history of asthma or atopy

Mark as Understood

© Institute of Clinical Science and Technology (ICST) 2020

Support: admin@clinicalscience.org.uk