A patient should immediately contract his/her doctor if any of the following conditions occurs:

• Cough increasing severely.
• Wheeze is loud or absent
• Breathlessness occurs at rest
• Pulse is >120/m (>160/m in children)
• PEFR is <50% of predicted value or personal best result.
• Response to bronchodilator treatment is not prompt and sustained for at least 3 hours.
• No improvement within 2 to 6 hours after oral rescue therapy.
• If peak flow result is at the red zone in a patient maintaining peak flow chart: