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You hear a shout from reception and attend quickly to see a breathless lady who has just walked in. You recognise her as Mrs Philips who is a 38 year old solicitor with Asthma. She is speaking clearly to you and saying she has noticed a flare in her Asthma over the last few days.

On examination her heart rate is 105, respiratory rate is 24 and oxygen saturations are 94%. Peak flow is 60% of her best recorded reading and auscultation of her chest reveals widespread wheeze.

How would you grade the severity of Mrs Philips’ asthma attack?

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