Box 10.1.

Description of indications for immediate transfer to hospital for children with acute asthma exacerbation

Indications	Description
Features of severe symptoms	Unable to speak and/or risk to chock with food or drink Bluish discoloration of lips and tongue (cyanosis)Rapid breathing >40/min for children <5 years of age Silent chest
Lack of response to rescuer treatment	Lack of response after 1-2 h of proper technique and dosage
Limitation to deliver acute treatment	Social, family, or environmental reasons