asthma in children Flashcards
sx of asthma
Cough
Breathlessness
Wheeze
Chest tightness
on exertion
IX of asthma
Serial peak flow readings, both when symptomatic and asymptomatic, as the airflow obstruction is reversible
Those suspected of having a high probability of asthma can be started on a trial of a short acting beta agonist
(SABA) inhaler
Where possible, spirometry should be performed in children - first line and BDR - bronchodilator reversibility
Where cases are unclear, FeNO testing may be helpful
Mx of asthma in children
what do you use as prefered method of delivery
spacer
inaled SABA PRN
lose dose ICS
3rd line - if on 200-400 micrograms a day then add - -over 5 then add LTRA or LABA if under 5 add LTRA
stop LABA then increse ICS
either increase dose of ICS after LTRA addition or
add theophyliine
spcialist care
nebulised Mgsulpahte if very sevree in acute hosptial setting
what is seen in complete asthma control
no nocturnal symptoms no daytime symptoms , no need for rescue meds, no asthma exacerbations, no limitations on activity including exercise , normal lung function, minimal side effects
CXR would show what
norm nothing sometimes hyperinflation
when should someone get the influenza vaccine
recommened to all patietns with astham taking reg corticosteriod therapy - nasal spray or IM
nasal spray CI in children with severe asthma on oral steriods as live attenuated vaccine
most common SE of salbutamol
tachycardia
if boy in severe asthma attack already had salbutamol via inhaler and nebuliser what do you do next
ipratropium bromide via nebuliser
if they dont respond to either get senior
if boy in severe asthma attack already had salbutamol via inhaler and nebuliser what do you do next
ipratropium bromide via nebuliser
if they dont respond to either get senior
if O2 sats drop below 92 what should you give to the patient
nebulised magnesium sulphate
