Acute asthma in paediatric patient

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most common chronic disease of childhood

leading cause of childhood morbidity of disease

school absences

EM presentations

hospitalisations

typically begins in early childhood

earlier onset in males vs females

Atopy with asthma in > 3years

risk factors

allergen specific

aeroallergen (dust mite, animal dander, fungi)

maternal diet during pregnancy / lactation (preventative)

pollutants (tobacco smoke, biomass fuels)

microbes + products

psychosocial

C-section higher #s than vaginal birth

definition

chronic inflammatory disorder of airways with assoc airway hyperresponsiveness

recurrent

wheeze (esp recurrent / with sleep / or with triggers - laughing or crying)

breathlessness

chest tightness

coughing

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DIAGNOSIS

difficult to Dx younger than 5 yrs

oft made on symptom patterns / clinical / FHx

DDx

Pharmacotherapy

inhaled via MDI with spacer (level A evidence for spacer) + mask if

controller medications

inhaled glucocorticoids

increased lung function

increased # Sx-free days

reduced exacerbations / need for adn medications