• Difficulty speaking due to breathlessness or excessive secretions in the upper airways.

• Signs of airway compromise including cyanosis, diminished breath sounds, or added sounds.

• Use of accessory muscles of respiration

• Patients with moderate-to-severe asthma episodes can present with tachypnoea and patients with severe-to-life threatening asthma episodes can present with bradypnoea, a sign of imminent respiratory failure.

• On auscultation: A wheeze might be heard during acute episodes, and more severe cases may present with reduced or absent air entry.

• On percussion: Areas of hyper-resonance or dullness might be identified, which could indicate conditions, such as pneumothorax, collapse or pleural effusion.

• On pulse oximetry testing: patients may present with reduced SpO2, the degree of which determines the patient’s risk/severity category.

• Tachycardia, as a result of stress or β-agonist use

• Hypotension, seen in severe asthma episodes

• Prolonged capillary refill time and cyanosis

Patients may present with reduced levels of consciousness or confusion, stemming from reduced oxygen delivery to the brain.

Acute episodes might be precipitated by allergens, so inspection of the patient might reveal signs of anaphylactic reaction, such as urticaria or angio-oedema.