Children with altered respiratory status
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| 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
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| 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.
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| 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.
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| 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
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| 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
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| 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
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