ACUTE ASTHMA EXACERBATION. TREATMENT IN A PEDIATRIC EMERGENCY DEPARTMENT

Abstract

Asthma is one of the most common chronic inflammatory respiratory diseases in childhood. Asthma exacerbation is a sudden flare-up of asthma symptoms, often resulting in respiratory distress (RD). Often, conventional treatment can be ineffective during an asthma exacerbation, so children are often referred to a pediatric emergency department. There are various underlying factors for asthma exacerbations. Viral respiratory infections are among the most common provoking factors. Other factors include allergens, air pollution, smoking, and poor asthma control. The main elements of the asthma exacerbation care pathway are rapid and objective assessment of symptoms and accurate differential diagnosis; appropriately prescribed medication and life support to improve oxygenation, reduce symptoms of RD and the risk of relapse; assessment of the condition in a dynamic manner, provision of care according to the observed condition; and development of a treatment plan. Basic management of asthma exacerbations: correction of hypoxemia; reduction of bronchospasm; management of airway inflammation: assessment of the condition dynamically; assessment of indications for further inpatient treatment; other treatments: antipyretics, ensuring adequate fluid intake; follow-up plan for the patient. Clear and precise follow-up recommendations should be formulated at the time of discharge home after an asthma exacerbation, both in terms of what the patient should take at home and how and when to contact the family physician or specialist.