You are the duty doctor. You get a call from reception to say that there is a patient who has arrived who is struggling to breath and appears very unwell. You quickly glance at your patient list and see that it is likely Mrs Dean, a 27 year old female who you had spoken to over the phone 30 minutes ago. She had called as she was concerned about her breathing but was talking in full sentences over the phone. You immediately assess Mrs Dean. She is clearly very distressed and struggling to breath, unable to complete sentences, has heart rate of 110, and a respiratory rate of 28, oxygen saturations are 93% and auscultation of her chest reveals widespread wheeze and crackles at the right base. She attempts but struggles to do a peak flow.

How would you grade the severity of Mrs Dean’s Asthma attack?

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