This guidance is designed to be used in practice to help diagnose and manage children with asthma and pre-school wheeze. Please click through the menus below to access the pathways and treatment recommendations. Each pathway is able to be downloaded for patient use but please only print when required to ensure you have the latest version available. 
Asthma
Pre-school wheeze
Asthma
Hospital
Diagnosis
Management
Hospital
Acute Treatment Pathway
Discharge Advice
SORT Guideline
Acute Treatment Pathway
This pathway is designed for use across the Children's Emergency Department and Paediatric Assessment Units​
Discharge Advice
6-11 years old
12+ years old
6-11 years old
To be used on discharge from hospital following acute treatment. 
Select the appropriate discharge plan based upon their personalised action plan
Using ICS AND as needed Salbutamol Reliever Therapy
Using Maintenance and Reliever Therapy (MART)
Using ICS AND as needed Salbutamol Reliever Therapy
Using Maintenance and Reliever Therapy (MART)
12+ years old
To be used on discharge from hospital following acute treatment. 
Select the appropriate discharge plan based upon their personalised action plan ​
Using ICS AND as needed Salbutamol Reliever Therapy
Using as needed MART (Symbicort or Duoresp Spiromax)
Using as needed MART Symbicort 100/3 MDI
Using as needed Anti-Inflammatory Reliever Therapy (AIR)
Using ICS AND as needed Salbutamol Reliever Therapy
Using as needed MART (Symbicort or Duoresp Spiromax)
Using as needed MART Symbicort 100/3 MDI
Using as needed Anti-Inflammatory Reliever Therapy (AIR)
SORT Guideline
Diagnosis
Use objective tests where possible to guide diagnosis.
If not available,  consider a trial of treatment
6-11 years old
12+ years old
6-11 years old
12+ years old
Management
6-11 years old
12+ years old
6-11 years old
Prescribing Guidelines
Personalised Action Plans
Prescribing Guidelines
Personalised Action Plans
Children and young people with a diagnosis of asthma require a personalised action plan that is regularly reviewed by health care professionals
Inhaled Corticosteroids AND as needed Salbutamol Reliever
Maintenance and Reliever Therapy (MART)
Inhaled Corticosteroids AND as needed Salbutamol Reliever
Maintenance and Reliever Therapy (MART)
Symbicort Turbohaler 100/6
Symbicort Turbohaler 100/6
12+ years old
Prescribing Guidelines
Personalised Action Plans
Prescribing Guidelines
Personalised Action Plans
Children and young people with a diagnosis of asthma require a personalised action plan that is regularly reviewed by health care professionals
Anti-Inflammatory Reliever Therapy (AIR)
Inhaled Corticosteroids PLUS as needed Salbutamol Reliever
Maintenance and Reliever Therapy (MART)
Anti-Inflammatory Reliever Therapy (AIR)
Inhaled Corticosteroids PLUS as needed Salbutamol Reliever
Maintenance and Reliever Therapy (MART)
Children >6years should be able to use a dry powder inhaler (DPI).
Consider Symbicort 100/3 MDI for those unable to use a DPI.
Children with anaphylaxis to milk should not use a dry powder device.
Symbicort Turbohaler or DuoResp Spiromax Inhaler
Symbicort 100/3 Metered Dose Inhaler (MDI)
Symbicort Turbohaler or DuoResp Spiromax Inhaler
Symbicort 100/3 Metered Dose Inhaler (MDI)
Pre-school wheeze
Document Version: 
1.0

Lead Authors: 
G. Connett (Respiratory Consultant, UHS)
S. Harper (Respiratory Specialist Nurse, UHS)
​L. Everitt (Respiratory Consultant, UHS)
Approving Network:
Wessex Paediatric Respiratory Network

Date of Approval: 
Sept 2024

Review Due:
Sept 2027