Asthma

Question 1

What are the features of a severe asthma attack in kids between 2-5 years?

Answer 1

SpO2 > 92%
PEF > 50% best or predicted
No clinical features of
severe asthma

Question 2

What are the features of life threatening asthma 9in ids between 2-5 years?

Answer 2

SpO2 <92%
Silent chest
Poor respiratory effort
Agitation
Altered consciousness
Cyanosis

Question 3

What are the features of a moderate asthma attack between 2 to 5 years?

Answer 3

SpO2 > 92%
No clinical features of severe asthma

Question 4

What are the features of a moderate asthma attack in kids > 5 years?

Answer 4

SpO2 > 92%
PEF > 50% best or predicted
No clinical features of
severe asthma

Question 5

What are the features of severe asthma attack in kids > 5 years?

Answer 5

pO2 < 92%
PEF 33-50% best or predicted
Can’t complete sentences in one breath or too breathless to talk or feed
Heart rate > 125/min
Respiratory rate > 30/min
Use of accessory neck muscles

Question 6

What are the features of life threatening asthma in kids > 5 years?

Answer 6

SpO2 < 92%
PEF < 33% best or predicted
Silent chest
Poor respiratory effort
Altered consciousness
Cyanosis

Question 7

What is the management for kids with mild to moderate asthma?

Answer 7

For children with mild to moderate acute asthma:

Bronchodilator therapy:
give a beta-2 agonist via a spacer (for a child < 3 years use a close-fitting mask)
give 1 puff every 30-60 seconds up to a maximum of 10 puffs
if symptoms are not controlled repeat beta-2 agonist and refer to hospital

Steroid therapy:
should be given to all children with an asthma exacerbation
treatment should be given for 3-5 days

Question 8

What is the usual steroid dose for > 5 years?

Answer 8

30 - 40 mg od

Question 9

What is the usual prednisolone dose for kids 2-5 years?

Answer 9

20 mg od

Question 10

What is the management of non acute asthma 5-16 years?

Answer 10

very similar to adults

Step 1: SABA

Step 2: SABA + ICS

Step 3: SABA + ICS + LTRA

Step 4: SABA + ICS + LABA

Step 5: SABA + ICS MART

Step 6: SABA + ICS MART or SABA + ICS + LABA

Step 7: SABA +

increased ICS either on it’s on or as part of MART
trial of theophylline
seek advice from asthma expertise

Question 11

What is the management of non-acute asthma in children < 5 years?

Answer 11

step 1: SABA

step 2: SABA + 8 weeks trial of ICS

step 3: SABA + ICS + LTRA

step 4 : stop LTRA and refer to paediatric specialist for asthma

Question 12

What is a MART?

Answer 12

ICS + LABA

Question 13

What dose is paediatric low dose of ICS?

Answer 13

< or equal to 200 micrograms of budesonide

Question 14

What dose is paediatric moderate dose of iCS?

Answer 14

200-400 micrograms of budesonide

Question 15

what is a paediatric high dose of ICS?

Answer 15

> 400 micrograms of budesonide