Suggested reasons for referral to a respiratory physician (taken from the British asthma guidelines32)
| Referral to an adult respiratory physician |
|---|
| • Patients in whom there is doubt about the diagnosis |
| • Patients with possible occupational asthma |
| • Those who present a management problem, for example |
| Brittle asthma symptoms despite high dose inhaled steroids |
| Those being considered for long term nebulised therapy |
| Asthma worsening in pregnancy; asthma interfering with lifestyle |
| Patients recently discharged from hospital |
| Referral to a respiratory paediatrician |
| • After a life threatening episode or admission to the ITU |
| • When asthma is very brittle |
| • When normal activity is severely restricted |
| • When special investigation is required |
| • When long term inhaled steroids are needed at doses above 800 μg/day |
| • When oral steroids are required regularly or in courses more than four times per year |