1 - Paeds - Resp - Asthma - BTS guidelines, Assessing Asthma Control, Parental Advice

Question 1

BTS/SIGN step 1 and 2

Answer 1

inhaled SABA PRN

add inhaled steroid (dose approp to severity)

Question 2

BTS/SIGN Step 3

Answer 2

Add LABA and assess asthma control. good response to LABA - continue. No resp to LABA - stop and try LTRA/theophylline. Benefit with LABA but inadequate control -> step 4

Question 3

BTS/SIGN Step 4

Answer 3

increase inhaled steroid to max recommended dose - if no resp > step 5 and refer to paeds resp

Question 4

BTS/SIGN Step 5

Answer 4

daily oral steroids in lowest dose for adequate control, refer to paeds resp. may need immsupp/modulation and psycho input

Question 5

assessing asthma control - what are you looking for?

Answer 5

poor asthma control - cough, wheee, SOB, difficulty walking/talking/sleeping, reduced relief from bronchodilators

Question 6

assessing asthma control - monitor what? assess what? what else is important?

Answer 6

monitor PEFR, assess compliance, correct usage, regime

pt education is v important, as well as inhaler technique

Question 7

parental advice- important things?

Answer 7

watch for signs of poor control, when, how, what to use, what if it worsens, can give oral pred for home if troublesome, give instructions and asthma action plan