‘Kids With Asthma’ Hit The Web: “A new interactive, kid-friendly website: http://www.kidswithasthma.com.au has been launched by the National Asthma Council Australia to give kids with asthma and their parents the low down on all-things asthma-related, including basic facts, diagnosis, asthma medications, management and FAQs.”
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There is an interesting article in “Chest, Jun 2001; 119: 1913 – 1929.” by Heinrich A. Werner, MD which may serve as a refresher in the diagnosis and treatment of children (and adults) in Status Asthmaticus. Although the definition varies, Status Asthmaticus may be defined as a condition of a patient deteriorating into respiratory failure from asthma which becomes unresponsive to conventional treatment modalities such as bronchodilator therapy.
The article describes presenting signs and symptoms and goes on to indicate that degree of chest wheeze does not correlate with severity of illness. Pulsus paradoxsis was found to be an excellant prognosticator of severity of asthma attack and can be one of the variables to be followed to determine effacacy of treatment, so long as fatigue and decreased level of conscientious do not occur.
The authour goes on to indicate that ABG’s should not be a basis for intubation, but rather be determined on clinical grounds.
Fluid replacment is important in the treatment of an asthmatic but NOT during an attack. Abics are not routinely considered as most attacks initiated by an infection are viral in nature.
During nebulizer therapy with a B-agonist such as salbutamol, the authour indicates that much less than 10% is depositied into the lung under ideal conditions. As a consequence he recommends an increase in dosage and a proper flow rate setting to optimize particulate size and depositon. (10-12 lpm for a particle size of 1-3 um).
