Question

What are the priority needs of children admitted with asthma exacerbation

Answer 1

Asthma

A long-term respiratory condition , in which the airways may unexpectedly and suddenly narrow, often in response to an allergen, cold air , exercise or emotional stress. Symptoms include wheezing, shortness of breath ,  chest tightness and coughing.

Priority needs of children admitted with Asthma Exacerbation:

Asthma Exacerbation in children is characterised by sudden increase of one or more typical asthma symptoms such as difficulty in breathing, coughing or chest tightness. Pre schoolers are in high risk of developing Asthma Exacerbation. Priority needs of children must be the following:

* Accurate and immediate assessment of disease severity.

* to decrease respiratory distress and to increase the oxygenation.

* plan for the care and unit for the child, after the emergency treatment .

Accurate and immediate assessment for the severity of the symptoms of Asthmatic exacerbation is necessary for the planning of effective treatment. Assess the symptoms of respiratory distress and airway obstruction. Monitor the oxygenation . Assess for previous intubation, life threatening condition , current use of Corticosteroids and past admissions to ICU. Physical examination and a spirometry also recommend to identify the airway obstruction.

One of the main goal of treatment for Asthma Exacerbation is to treat hypoxia and decrease respiratory distress. Administer oxygen , in case of hypoxemia, and short acting bronchodilators( salbutamol) with a metered - dose inhaler as per physician's order .  If the child is suspecting with Anaphylaxis, then treat him with Epinephrine. As an initial treatment for Asthma Exacerbation in children, systemic steroids should be given ( Methyl prednisolone) to treat inflammation and to prevent relapse. Aminophilline and salbutamol Iv infusion also may be recommended.

In case of respiratory failure Endotracheal intubation and ventilation should be performed.

Appropriate disposition of child should be planned, immediately after giving the emergency treatment, either to ICU or to inpatient wards or for the out patient care.