A 3 year-old boy presents accompanied by his Dad. He suffers with asthma for which he takes a salbutamol inhaler as required. He has been coryzal for the past few days and has become wheezy this evening. His best peak flow is 250 L/min and his peak flow this evening is 180 L/min. His observations are as follows: HR 100, RR 26, SaO2 97% on air, Temperature 37.4°C.
How would you classify his asthma at this presentation? (1)
Outline your initial management in the ED: (3)
What are the normal ranges for heart rate and respiratory rate in a child this age? (2)
He responds to your initial treatment. Outline your discharge plan: (2)
List 4 features of acute severe asthma in this age group: (2)
Answers in British Thoracic Society (BTS) Guidelines for Asthma (need to know Adults and Paeds criteria for classification - e.g. life threatening, severe, moderate, mild
(Courtesy: Dr Shweta Gidwani, London (UK))
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