asthma in children r Flashcards
what causes bronchoconstriction in asthma
smooth muscle contraction in the airways
what are the three key features for asthma
wheeze
variability
responds to treatment
symptoms of asthma
wheeze
cough
SOB
common triggers for asthma
pets dust cold air exercise smoke food allergens
investigations in asthma
no diagnostic test - see if it responds to treatment
spirometry
peak flow
management if QoL is not affected
watchful waiting
step 1 in management for under 5s
short acting b2 agonist (SABA)
- salbutamol
step 2 in management for under 5s
add low dose ICS
or
add leukotriene receptor antagonist
step 3 for management in under 5s
add the other option from step 2
step 4 for management in under 5s
refer
step 1 for ages 5-12
SABA
step 2 for ages 5-12
add low dose ICS
step 3 for 5-12s
add LABA (salmeterol)
step 4 for 5-12s
increase ICS dose
add oral leukotriene receptor antagonist
or
add oral theophylline
step 5 for 5-12s
increase dose of ICS
step 1 for ages 12+
SABA
step 2 for 12+
add ICS
step 3 for 12+
add LABA
step 4 for 12+
increase ICS dose
add OLR
or
oral theophylline
step 5 in age 12+
increase dose of ICS again
general management in asthma
create an asthma action plan
assess the childs inhaler technique
remove triggers
stop smoking
treatment of mild acute asthma
SABA with spacer
SABA + oral prednisolone
treatment of moderate acute asthma
SABA via nebuliser + oral prednisolone
SABA via nebuliser + oral prednisolone + ipratropium
treatment of severe acute asthma
IV salbutamol IV aminophylline IV magnesium IV hydrocortisone intubate + ventilate
how could you measure control of asthma
SANE SABA use absence from school/nursery nocturnal symptoms exertional symptoms
what presents the same and is managed the same as asthma in children
viral induced wheeze
