Asthma Management and References - Peak Flow Measurement (PEFR)

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ASTHMA IN CHILDREN

Dr C.T.Deshmukh
Professor of Pediatrics, K.E.M Hospital

Asthma Management and References

The diagnostic phase in a child with acute asthma should be short and comprise a brief history taking, inspection and auscultation of the thorax, transcutaneous oxygen measurement and, if possible, peak flow measurement ( PEFR ).

Patients should be treated immediately with oxygen , which should always be humidified.

β 2-agonists should be given immediately by inhalation if they are capable of effective inhalations or by injection if severely dyspneic. Frequent doses should be given and the duration and effect can be monitored by clinical assessment and PEFR measurement.

High dose corticosteroids should be administered promptly by mouth if there is no concern regarding retention, and parenterally if the patient is obtunded or vomiting.

Monitor clinical parameters, pulse oximetry and PEFR. PEFR should be monitored every 30 minutes until patient is out of danger.

Blood gases should be done if :
1) O2 saturation < 94 % at room air and patient dyspneic or
2) O2 saturation < 90 % regardless of clinical findings.

After initial management one has to decide if patients needs hospitalization or needs to be sent home on medication.

Next : Asthma Management and Refrences(Contd.)

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ASTHMA IN CHILDREN : QUESTIONS AND ANSWERS

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