Acute asthma in children; guidelines by pediatric pulmonologists for diagnosis and treatment
van Nierop, J.C.; van Aalderen, W.M.; Brinkhorst, G.; Oosterkamp, R.F.; de Jongste, J.C.
Nederlands Tijdschrift Voor Geneeskunde 141(11): 520-524
1997
ISSN/ISBN: 0028-2162 PMID: 9190508 Document Number: 477484
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. Blood picture. sputum culture and chest X-ray may be included in the diagnostics if indicated. The primary treatment consists of administration of bronchodilators (beta-2 sympathicomimetics) by inhalation, using a spacer. Repeated inhalation of salbutamol and ipratropium may be necessary. In case of inadequate improvement (spraying necessary every 3 hours for 24-48 hours), hospitalization and systemic administration of corticosteroids are indicated. Other reasons for hospitalization are a transcutaneous oxygen saturation lower than 91%, complications such as subcutaneous emphysema and pneumothorax, exhaustion of child or parents, and rapid aggravation of the clinical picture with rising Pco2 and falling pH in capillary or arterial blood.