Mark Hobson
Journal of Paramedic Practice, Vol. 9, Iss. 8, 04 Aug 2017, pp 334 - 338

In 2014, the National review of Asthma Deaths recognised the significant
burden of associated morbidity, amongst avoidable factors and recent contact
with healthcareprofessionals that commonly occur prior to a fatal asthma
exacerbation. It also recognised delayed and undersupply of preventer
medications, particularly oral steroids, that are linked to relapsing into a repeat
exacerbation. Oral steroids are not without significant systemic side effects and
carry their own risks which must be balanced against the risk of relapse. This
literature review seeks to establish if oral steroids should be routinely supplied
to prevent asthmatic relapse. Exacerbations induced by viruses, allergies and
medications are commonly known to contribute towards deterioration and these
high risk patients have been found to gain the most benefit from a 7-10 day
course of oral steroids. This is recommended as an effective, cheap and safe
option with minimal side effects for higher risk patients. Paramedics should
consider supplying, or obtaining a supply of oral steroids for high risk asthmatics
following an acute exacerbation of asthma when the patient does not require,
or refuses, further assessment or observation in an accident and emergency

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