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ASTHMA

Asthma is a chronic inflammatory disease of the airways that causes symptoms ranging from mild to severe. It can be triggered by allergens and irritants, which cause inflammation and constriction of the airways. Acute severe asthma, also known as status asthmaticus, is a medical emergency characterized by progressively worsening symptoms despite usual treatments. Its management involves administering oxygen, bronchodilators, steroids, and monitoring for complications such as pneumothorax. Follow up care includes continued steroids, inhalers, and education on precipitating factors and warning signs.

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Ayesigwa Gerald96
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3K views16 pages

ASTHMA

Asthma is a chronic inflammatory disease of the airways that causes symptoms ranging from mild to severe. It can be triggered by allergens and irritants, which cause inflammation and constriction of the airways. Acute severe asthma, also known as status asthmaticus, is a medical emergency characterized by progressively worsening symptoms despite usual treatments. Its management involves administering oxygen, bronchodilators, steroids, and monitoring for complications such as pneumothorax. Follow up care includes continued steroids, inhalers, and education on precipitating factors and warning signs.

Uploaded by

Ayesigwa Gerald96
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
  • Introduction to Asthma in Children: Presents the topic and the presenter, setting the stage for the discussion on asthma in children.
  • Definition of Asthma: Defines asthma, describing its nature and potential severity if untreated or under-treated.
  • General Signs and Symptoms: Lists the clinical signs and symptoms of asthma to aid recognition and diagnosis.
  • Risk Factors: Details familial and environmental risk factors associated with the development of asthma.
  • Triggers of Asthma: Explores both allergic and non-allergic triggers that can exacerbate asthma symptoms.
  • Pathophysiology: Provides a detailed explanation of the physiological processes involved in asthma attacks.
  • Acute Severe Asthma (Status Asthmaticus): Describes the clinical features and implications of severe asthma that do not respond to standard treatments.
  • Management: Outlines the emergency and follow-up management protocols for treating asthma in children.
  • Supportive Therapy: Describes supportive care measures to stabilize children experiencing severe asthma attacks.
  • Investigations: Lists the diagnostic investigations to be conducted for comprehensive asthma assessment.
  • Cautions: Advises cautionary steps and considerations in treatment to ensure comprehensive care.
  • Complications: Discusses potential serious complications of asthma that require medical intervention.
  • Follow Up: Provides guidelines on post-discharge care to prevent relapse and manage mild asthma attacks effectively.

ASTHMA IN CHILDREN

presented by Mbekeka Angella

presented by Mbekeka Angella


Defnition
Asthma is a chronic inflammatory disease of the
airways. Symptoms range from mild to severe,
intermittent to chronic.
Untreated or under treated, asthma can lead to severe
respiratory distress and in rare cases, sudden death.
It can be classified into acute and chronic asthma.

presented by Mbekeka Angella


GENERAL SIGNS AND SYMPTOMS OF
ASTHMA
Wheezing
Chronic or recurrent cough
Tight feeling in the chest
Shortness of breath
Rapid breathing
Nasal flaring
Anxiety
Feeling weak or tired

presented by Mbekeka Angella


Risk factors for developing asthma

A family history of allergy, eczema and asthma


Smoking in the home.
House dust and dust mites.
Premature Births < 36 weeks of gestation.
Presence of Pets in families

presented by Mbekeka Angella


Triggers:
Allergic- such as dust mites
Non-allergic- such as exercise, viral infections, smoke or
other irritants.
These triggers cause inflammation and afterwards,
tightening of the airway muscles.
Only those with allergic asthma have symptoms triggered
by allergens such as pet dander, pollen and dust mites.
About 80- 90 % of adults with asthma have allergic
triggers.

presented by Mbekeka Angella


Cont
The body attempts to expel the allergen/s by releasing
several chemicals including histamines, causing
sneezing, runny noses, watery eyes and broncho-
constriction.
Histamines cause bronchial smooth muscles to
contract which in turn, makes exhaling more difficult.
In a child with asthma, histamine can also trigger
asthma symptoms.

presented by Mbekeka Angella


Pathophysiology
Incase of a trigger factor for example allergens the
body tries to produce chemical histamine which brings
about a running nose, watery eyes and Broncho
constriction. These histamines in excess cause smooth
muscles of the bronchus to constrict making exhaling
very difficult bringing about a difficult in breathing,
wheezing etc.
There excess histamine release in the body tend to
exacerbate asthma attacks.

presented by Mbekeka Angella


Acute severe asthma. (STATUS
ASTHMATICUS)
Clinical diagnosis is defined by increasingly severe
asthma not responsive to drugs that are usually
effective.

presented by Mbekeka Angella


Features of acute severe asthma
Cyanosis or SaO2<92%.
Severe chest retractions and use of accessory muscles.
Inability to talk in an older child.
Silent chest on auscultation (minimal air exchange).
Pulsus paradoxicus >20mmHg (the difference in
systolic arterial blood pressure in inspiration and
expiration doesn’t normally exceed 10mmHg).
Lethargy or changes in mental status.
Hypercapnia (CO2 retention-PaCO2
>50mmHg/>7kpa.

presented by Mbekeka Angella


Management
Before specific therapy the patient must be given high
flow oxygen.
Subcutaneous adrenaline 0.01ml/kg/dose (max 0.3ml)
can be repeated twice, 20min apart.
Nebulised salbutamol or albuterol given every 3hrs.
IV hydrocortisone 6mg/kg/dose 6hrly for 24hrs.

presented by Mbekeka Angella


Management -cont
IV aminophyline 6mg/kg as a loading dose and then
5mg/kg/dose every 6hrs or 1mg/kg/hr. watch out for
signs of toxicity like tachycardia, vomiting,
arrhythmias.
Prednisolone orally 1-2mg/kg/day for 5 days.
No sedation should be given even if the child is
restless.

presented by Mbekeka Angella


Supportive therapy
Give oxygen at a concentration of 100%. Remember
all children with severe asthma are hypoxic. The SaO2
should be >95%.
Maintain hydration by IV fluids or NGT.
Antipyretics should be given if the child is febrile.
Antibiotic should be considered if particularly the
child has a high temperature or localizing signs on
CXR.

presented by Mbekeka Angella


Investigations
FBC
Oxygen saturation, capillary or arterial blood gases..
Blood chemistry- Na, K, Cl, bicarbonate, and glucose.
Chest X-Ray.

presented by Mbekeka Angella


Cautions
If despite the above treatment the child’s condition
does not improve or worsens, then refer immediately
to the intensive care ward for intubation and artificial
ventilation.
Remember that all that wheezes is not only asthma.
Consider other possibilities if it is the first episode and
response is poor.

presented by Mbekeka Angella


Complications
Pneumothorax .
Lung collapse.
Mediastinal empysema.

presented by Mbekeka Angella


Follow up
Continue oral steroids at discharge for a total of 5
days.
Metered dose inhaler of β2 agonists for mild
attacks.
Home nebuliser for moderate asthma attacks.
Inhaled steroids or sodium chromoglycate if the
child has recurrent admissions for severe asthma.
Counselling of the child about precipitating factors
(e.g. pollution, smoking, dust), explain drug
management and when they should bring their
child to hospital (e.g. signs of severe distress: baby
not breastfeeding, child unable to talk.)
presented by Mbekeka Angella

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