High probability of respiratory viral infection (beginning of day care/preschool term, epidemics) Confirmed food allergy or history of anaphylaxis Poor asthma symptom control ED visit or admission to hospital for asthma in preceding 12 months History of sudden, unpredictable exacerbations not preceded by gradual worsening of symptoms History of intubation/paediatric ICU admission for acute asthma Over-use of salbutamol Poor adherence to prescribed ICS treatment by parents/carers Poor inhaler technique for ICS Frequent failure to attend consultations Parent’s/carer’s inability to follow asthma action plan Significant parental psychological or socioeconomic problems Carer unequipped to manage asthma emergency Exposure to clinically relevant allergens Exposure to tobacco smoke Damp housing Exposure to outdoor pollution Obesity High eosinophil count (if known) |