Acute Paediatric Emergencies 2

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Acute Paediatric Emergencies 2

• Asthma
• Dr Julia Thomson
• General paediatric consultant with an interest in
  Emergency Paediatrics

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Learning objectives

• Assessment and support of a child with breathing
  difficulties
• Approach to the child with wheeze
• Asthma emergency treatment

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Background

• Acute exacerbation of asthma is most common
  reason for hospital admission in UK
• Cough, wheeze, breathlessness
• Precipitants
• Viruses
• Smoky atmosphere, other pollutants
• Rapid fall in temperature
• Exercise
• Allergens
• 26 deaths from asthma in England and Wales in
  2002

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Assessment of the child with breathing
difficulties

• Assess and if necessary support
• A,B,C
• AIRWAY
• BREATHING
• Effort, (Exceptions), Efficacy, Effects
• CIRCULATION

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Approach to the child with wheeze

• Assess severity BTS/SIGN 2008 guidelines
• Moderate
• Acute severe
• Life-threatening
• Elements in the history associated with
  severe/life-threatening attacks
• Long duration of symptoms
• Regular nocturnal awakening
• Poor response to any treatment already given in
  this episode
• Previous ITU admission, iv salbutamol

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After care

• Potassium
• Antibiotics?
• Cessation of iv treatment
• Duration of steroids
• Iv fluids
• Discharge plan

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Questions
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Summary

• Assessment and support of a child with breathing
  difficulties
• ABC
• Approach to a child with wheeze
• Asthma emergency management as per BTS/SIGN
• Management on discharge