Asthma and other recurrent wheezing disorders in children (acute)


Asthma is a chronic inflammatory disease of the airways characterised by episodic wheeze and reversible airway obstruction. Acute exacerbations of asthma are characterised by tachypnoea, increased work of breathing (chest wall recession in young children and use of accessory muscles in older children), tachycardia, and reduced oxygen saturations. Acute childhood asthma is a common clinical emergency presenting across a range of ages and with a range of severities. This review was designed to assess the current evidence for best management of acute childhood asthma. Acute asthma may be classified into the following categories: severe acute asthma: oxygen saturations <92%, pulse >125 beats/minute (>5 years) or >140 beats/minute (2–5 years), respiratory rate >30 breaths/minute (>5 years) or >40 breaths/minute (2–5 years), obvious use of accessory muscles (>5 years) or obvious chest wall recession (2–5 years), unable to complete sentences in one breath (talks in 1–2 words), too breathless to feed; [1] moderate acute asthma: oxygen saturation 92–95%, pulse 100–125 beats/minute (>5 years) or 120–140 beats/minute (2–5 years), respiratory rate 20–30 breaths/minute (>5 years) or 30–40 breaths/minute (2–5 years), some use of accessory muscles (>5 years) or some chest wall recession (2–5 years), talks in short phrases.

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