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Peds Respiratory

Children with altered respiratory status

Differences with children's respiratory systems Smaller and functionally immature - less reserve capacity. More vulnerable to resp illnesses and complications. Develop resp distress and failure much more readily. Obligate nose breathers. Tongue larger in proportion to mouth (obstruction). Airway smalle
How are levels of severity of asthma determined? Both impairment and risk. Impairment assessed by caregiver's recall of previous 2-7 weeks, and assign to the most severe category in which any feature occurs.
What are the levels of severity of asthma? Intermittent and persistent (mild, moderate or severe); each is subcategorized by ages 0-4 and 5-11.
Mild persistent 5-11 Sx >/= 2 days/wk-not daily Nighttime wake 1-2x/month Beta2-agonist >/= 2days/wk Minor limitation/activity Exacerbations: >/= 2 in 6 mos or >/= 4 wheezing/yr STEP 2
Moderate persistent 5-11 Sx Daily Nighttime wake >1x/wk Beta2-agonist daily Some limitation/activity Exacerbations: >/= 2 in 6 mos or >/= 4 wheezing/yr STEP 3 medium-dose ICS and consider short course oral systemic corticosteroids
Severe persistent 5-11 Sx throughout the day Nighttime wake Often 7x/wk Beta2-agonist several/day Extremely limited activity Exacerbations: >/= 2 in 6 mos or >/= 4 wheezing/yr STEP 3 medium-dose ICS OR STEP 4 and consider short-term oral systemic corticosteroids
Created by: kscott59