Which symptoms are considered red flags for severe asthma exacerbations?

The symptoms that are classified as red flags for severe asthma exacerbations include declining mental status and persistent hypoxia. This is because these signs indicate a significant compromise in the patient’s respiratory function and the potential for life-threatening conditions.

Declining mental status can suggest inadequate oxygenation, where the brain is starting to be impaired due to lack of oxygen, often signaling that the respiratory system is not capable of delivering adequate ventilation and gas exchange. Persistent hypoxia, characterized by low oxygen levels in the blood, indicates that despite the body’s effort to breathe, there isn’t enough oxygen being supplied to essential organs. Both symptoms suggest a critical state requiring immediate medical attention.

In contrast, increased energy levels would typically not be associated with an exacerbation of asthma symptoms and could mislead one into thinking the patient is doing well. Decreased respiratory effort might imply that a patient is too fatigued or severely worsening, but on its own, it doesn't explicitly signal an exacerbation. Lastly, stable peak flow readings suggest that the patient’s asthma is under control, which does not align with the indicators of a severe exacerbation. Therefore, recognizing declining mental status and persistent hypoxia is crucial in identifying patients at risk of a severe exacerbation.