Managing acute asthma in children

Abstract

Acute asthma is the most common medical emergency in children. Despite the widespread distribution of national guidelines∩ treatment is variable and often suboptimal. Audit has shown that clinical guidelines improve the outcome of children treated in emergency departments with asthma. The assessment of children with asthma is different from that in adults and this may lead to the severity being underestimated. Core therapies including oxygen, high-dose inhaled β2gonists and oral steroids should be initiated without delay following assessment. Second-line therapies including inhaled ipratropium and parenteral aminophylline may be considered if the child is not improving. If there is no clear improvement, failure of treatment needs to be considered as children may deteriorate rapidly.Children presenting to an emergency department with asthma, often have poor background control and the opportunity to review chronic therapy and provide education should not be missed.