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Lecture notes Acute Care (SHN2004)

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Care of child with asthma

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SHN2004 – Asthma in Children


Care of child with asthma
What causes asthma?
 It is difficult to say for sure what causes asthma. What we do know is that you are more
likely to develop asthma if you have a family history of asthma, eczema, or allergies.
 It is likely that this family history, combined with certain environmental factors,
influences whether or not someone develops asthma.
 Many aspects of modern lifestyles – such as changes in housing and diet and a more
hygienic environment.

Principles
 Asthma is a variable disease which can change throughout a person’s life, throughout
the year and from day to day.
 Symptoms resulting from poor control of underlying inflammation are common and vary
in frequency and severity.
 Many children and their families have a poor perception of their asthma and mistakenly
believe that these symptoms are normal and should just be accepted.

Morbidity
 Common physical morbidity factors include:
- Frequent symptoms
- Asthma attacks
- Sleep disturbance
- Difficulty concentrating on schoolwork
- Activity avoidance
- School absence
 Common emotional morbidity factors include:
- Fear
- Anxiety
- Feeling different to peers
- Social isolation
- Families are also likely to be affected

Mortality
 Every year, 20-40 children in the UK die from asthma.
 Example of preventable factors include:
- Incorrect prescription or use of medication
- Poor recognition of the onset of asthma attacks
- Poor appreciation of the potential severity of asthma attacks

Characteristics
 Respiratory symptoms in young children are very common and usually related to the
frequent viral infections that children experience.
 For children under 5 with suspected asthma, treat symptoms based on observation and
clinical judgement, and review the child on a regular basis (NICE,2017)
 The key characteristics of asthma are:
- Variability
- Intermittency

, SHN2004 – Asthma in Children


- Reversibility

Asthma: Pathysiology




 In response to allergens or triggers, the lining of the bronchioles become swollen,
inflamed and oedema is present within the bronchial tissue.




Asthma triggers
 A trigger is anything that irritates the airway and causes the symptoms of asthma.
 Everyone’s asthma is different and a person with asthma may have several triggers.
 An importance aspect of controlling asthma is avoiding triggers.
 It can be difficult to identify what triggers asthma in a particular individual.

Asthma-Diagnosis
 Diagnosiscan be problematic as there is no one definitive
test that can
Diagnosis can be problematic as there is no one definitive test that can be used to confirm this,
therefore diagnosis should be based on: -
- Full history including allergies
- Physical examination
- Results of spirometry
- Response to bronchodilator

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