In asthma management, discharge with close follow-up and oral steroids is considered when positive expiratory pressure improves by what percent?

• A. 30-50%
• B. 60-80%
• C. 80-100%
• D. 0-10%

Answer: (B)

In acute asthma, how well airways respond to bronchodilator therapy is a key signal for disposition. We track the change in expiratory flow (often peak expiratory flow, or a similar measure) from the patient’s baseline after treatment. When that expiratory flow improves by about 60–80%, it shows a substantial, clinically meaningful reversal of obstruction. This level of improvement indicates the patient is stable enough for discharge with close follow-up, and a short course of oral steroids helps consolidate the response and reduce the chance of relapse.

If the improvement is minimal (0–10%) or only modest (30–50%), the airway obstruction remains significant, so continued observation or hospitalization is appropriate. If improvement were extremely high (80–100%), that suggests near-complete reversal and could also support discharge, but the 60–80% range is the well-established threshold used to balance safety with the need to avoid unnecessary hospitalization.