A 3- year old boy is brought to the casualty-by his mother with progressive shoness of breath for 1 day. The child has history of bronchial asthma. On examination, the child is blue, gasping and unresponsive What will you like do first?
Correct Answer: Administer 100 % oxygen by mask
Description: This child is showing features of acute severe asthma. In patients with acute severe asthma there is inadequate minute ventilation and V/Q mismatching as a result they will almost be hypoxic and should immediately receive supplemental humidified oxygen immediately to maintain saturation more than 90%. Following oxygen they should be given: Sho acting beta2 agonists(nebulization or IV) S.c epinephrine or terbutaline IV steroids If respiratory failure sets in invasive ventilation might be required. Signs of acute severe asthma includes: Dyspnea at rest Inability to speak Use of accessory muscles of respiration Cyanosis Silent chest Altered level of consciousness Pulsus paradoxus Ref: CURRENT Diagnosis & Treatment: Pediatrics, 21e chapter 14, By Joseph A. Albietz III, MD
Category:
Pediatrics
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