![]() ![]() One study of children up to 18 years of age presenting to the emergency department with acute asthma symptoms identified multiple risk factors for a subsequent emergency department visit: age younger than two years, black race or Hispanic ethnicity, persistent asthma, public health insurance, lower asthma quality-of-life scores, and increased use of the health care system during the previous 12 months. Airway inflammation can persist for days to weeks after an acute attack therefore, more intensive treatment should be continued after discharge until symptoms and peak expiratory flow return to baseline. The administration of systemic corticosteroids within one hour of emergency department presentation decreases the need for hospitalization, with the most pronounced effect in patients with severe exacerbations. Intravenous magnesium sulfate has been shown to significantly increase lung function and decrease the necessity of hospitalization in children. ![]() Multiple doses of inhaled anticholinergic medication combined with beta 2 agonists improve lung function and decrease hospitalization in school-age children with severe asthma exacerbations. In the ambulatory and emergency department settings, the goals of treatment are correction of severe hypoxemia, rapid reversal of airflow obstruction, and reduction of the risk of relapse. Administration using a hand-held metered-dose inhaler with a spacer device is at least equivalent to nebulized beta 2 agonist therapy in children and adults. In patients with a peak expiratory flow of 50 to 79 percent of their personal best, up to two treatments of two to six inhalations of short-acting beta 2 agonists 20 minutes apart followed by a reassessment of peak expiratory flow and symptoms may be safely employed at home. Criteria for exacerbation severity are based on symptoms and physical examination parameters, as well as lung function and oxygen saturation. Asthma exacerbations can be classified as mild, moderate, severe, or life threatening. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |