Treatment of the asthmatic child in the hospital
Sifontes, J.E.; Mayol, P.M.; Fernando Rivera, J.; Piovanetti, I.
Boletin de la Asociacion Medica de Puerto Rico 74(4): 113-122
1982
ISSN/ISBN: 0004-4849 PMID: 6960897 Document Number: 5950
The asthmatic patient who arrives at the emergency room should be evaluated and managed immediately. The following outline of management is suggested: (1) Ilistory and physical examination rapidly performed and directed to what is relevant. (2) Identify promptly the patients who may be managed in the emergency room or who need hospitalization. (3) Treat with epinephrine and, if available, with β 2 agonists in aerosol. (4) if there is no significant prompt improvement, administer aminophylline by the intravenous route. (5) Oxygen therapy. (6) Adequate but not excessive hydration. (7) Corticosteroids without delay -do not wait for the patient to deteriorate. (8) Record progress in flow graphs or tables in which the following are noted at ½, 1, 2 or 3 hour intervals as needed (table 9): (a) clinical score, (b) peak flow rates or spirometry (if available), (c) bood pressure, cardiac and respiratory rates, (d) blood theophylline levels (if done), (e) arterial bood gases (if done). (9) Laboratory tests as indicated: (a) chest roentgenograms, (b) complete blood count includíng hematocrit, (c) urinalysis including specific gravity, (d) stools for ova and parasites, (e) tuberculin test, (1) blood gases and electrolytes. (10) If hospitalization is needed his should be at the intensive or special care unit where the patient can be monitored continually until stabilized.
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