14588757
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
almost 6 years ago
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| Question | Answer |
| 1. TRUE/FALSE? A. The dose of salbutamol for acute asthma is 6 puffs (via spacer) or 2.5mg (via nebuliser) in children below 6 years of age. | True. The dose of salbutamol for acute asthma episodes is 6 puffs (via spacer with mask) or 2.5mg (via nebuliser) for children under 6 years of age and 12 puffs via spacer or 5mg (via nebuliser) for children 6 years of age and over. |
| 1. TRUE/FALSE? B. In children below 6 years of age, systemic steroid therapy should be reserved for moderate to severe asthma episodes, particularly those requiring hospitalisation. | True. Systemic steroid therapy via the oral or IV route is currently mandated in all moderate to severe cases of asthma and provided as an option in children with mild acute asthma. However, there evidence suggesting that in preschoolers with viral induced wheeze, oral corticosteroids are not more effective than placebo. Thus in the preschool age group, threshold should be raised and they should generally be reserved for children requiring hospitalisation. |
| 1. TRUE/FALSE? C. The current recommended dose of oral prednisolone in moderate to severe asthma flare up is 1-2mg/kg (max 50mg) initial dose and 1mg/kg/day given for three to five days. | True. Most guidelines suggest between 1-2mg/kg as the initial dose (maximum 50mg) and 1mg/kg/day given for three to five days. The recently revised NAC Australian Asthma Handbook advises an initial dose of 2mg/kg (maximum 50mg) followed by 1mg/kg on days 2 and 3. Alternatively methylprednisolone 1mg/kg or hydrocortisone 4mg/kg 4-6 hourly may be given IV. |
| 1. TRUE/FALSE? D. Carbon dioxide retention detected on a venous or arterial blood gas is suggestive of a moderate acute asthma episode. | False |
| 1. TRUE/FALSE? E. Pulse oximetry during acute asthma episodes is a good guide for discharge from hospital. | False |
| 1. TRUE/FALSE? F. A chest X-ray is indicated during every episode of acute asthma in a child | False |
| 2. 2yo presents to hospital and is treated for a mild episode of acute asthma. Parents had been treating at home with salbutamol via spacer without much response over 12 hours. Good response to standard management in hospital. TRUE/FALSE - what factors may have contributed to lack of response to treatment at home? A. Parents did not initiate oral steroids at home | False |
| TRUE/FALSE - what factors may have contributed to lack of response to treatment at home? B. Parents used a spacer device as opposed to a nebuliser which is more effective in young children. | False |
| TRUE/FALSE - what factors may have contributed to lack of response to treatment at home? C. Parents were giving 2 puffs of salbutamol four hourly. | True. Always check whether the child is receiving the right dose of salbutamol. In this case, 6 puffs at a time given up to a frequency of every 3 hours. If a child needs salbutamol more frequently than this, medical help needs to be sought promptly. During an acute asthma flare-up a child may need frequent (eg. 3 x20 minutes) puffs for the initial hour to allow the airways to open sufficiently. In a severe episode there may be a need to continue more frequently. |
| TRUE/FALSE - what factors may have contributed to lack of response to treatment at home? D. You checked the technique of spacer use and the parents had been administering one puff followed by one breath and then the next puff. | True. Always check the technique of administration of the asthma medication at every opportunity. In this case the child should have been given one puff via the spacer device with mask followed by four to six breaths and then the next puff, continuing this process until all six puffs have been delivered. |
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