Lecture Day 2 Childhood Asthma

Question 1

What is the common cause of PICU admission

Answer 1

Asthma

Question 2

Pathophysiology of asthma

Answer 2

Increased airway reactivity
Mucosal oedema / airway inflammation
Bronchoconstriction
Hyper-secretion of mucus

Question 3

Common triggers

Answer 3

Dust mice
Pets
smoking 
cold wether 
exercise 
dust
mold
pollen

Question 4

Hx

Answer 4

Improvement of correct Tx
Birth Hx: Preterm birth
Family Hx: atopy
Social Hx: smoking, poor housing, schooling (missed days)

Question 5

How to diagnose in under 5’s

Answer 5

Has to be clinical observation as they can not do tests

- when child is over 5 then do tests to confirm diagnosis

Question 6

Management of asthma

Answer 6

patient & parent education
avoid triggers
Tx ladder

Question 7

Tx ladder under 5s

Answer 7

Step 1: Inhaled short-acting B2 agonist PRN
Step 2: Add inhaled steroid 200-400mcg/day
Step 3: Leukotriene receptor agonist (if under 2 go to step 4)
Step 4: refer to resp paed

Question 8

Tx ladder 5-12

Answer 8

Step 1: Inhaled short-acting B2 agonist PRN
Step 2: Add inhaled steroid 200-400mcg/day
Step 3: add LABA
Step 4: ↑ steroid to 800mcg/day
Step 5: daily steroid tablet + refer resp paid

Question 9

How to give inhaler

Answer 9

< 5 pMDI + spacer device

Question 10

Good asthma control

Answer 10

No daytime symptoms
No nocturnal symptoms
No need for rescue treatment
No exacerbations
Normal exercise tolerance
Normal lung function (PEFR > 80%)

Question 11

What age is peak flow is suitable

Answer 11

When can follow instructions

Question 12

How much oxygen can a nasal cannula provide?

Answer 12

2L

Question 13

What is an acabella device? What is it used for?

Answer 13

aids moving sputum and losening sputum.

CF

Question 14

Colour of spaces

Answer 14

To fit correctly around face, good seal.

Question 15

Areochamber

Answer 15

blue, don’t need to fit

Question 16

Advise how to give inhaler to baby

Answer 16

Sitting
one hand behind back
Hold in one arm and hold hand down with same arm 
Use free hand to give inhaler 
Can use your legs to keep to hold babies legs
give one puff & count to 8
repeat
if screaming thats ok, as taking in drug