CUH Paediatric Asthma Guidelines
Broad recommendations
PASS (Paediatric Asthma Severity Score)
| 0 | 1 | 2 | |
|---|---|---|---|
Wheeze |
None |
Moderate |
Severe/absent |
Work of breathing |
None |
Moderate |
Severe |
Prolonged Expiration |
None |
Moderate |
Severe |
- Initial treatment is based on severity of clinical condition as determined by PEFR or the Paediatric Asthma Severity Score (performed by admitting doctor).
- Subsequent treatment is based on response.
- Initial treatment is multidose β2 agonists via metered dose inhalers with spacer (+/- mask/mouthpiece).
- Oral steroids to be given early.
- Inhaled Ipratropium bromide to be given early in moderate and severe asthma/wheeze.
- Life threatening asthma guidelines
- Intravenous Aminophylline and β2 agonists to be added if severe episode.
- Consider the use of intravenous Magnesium sulphate if response unsatisfactory.
- In Infants- Commence treatment with Ipratropium bromide (No good evidence).
Management asthma in under 2 year olds life threatening asthma
References/Source Documents
British Thoracic Society; Scottish Intercollegiate Guidelines Network. British Guideline on the Management of Asthma. Thorax. 2003 Feb; 58 Suppl 1: 1-94
British Thoracic Society; Scottish Intercollegiate Guidelines Network. 2005 Update to the British Guideline on the Management of Asthma, originally published in 2003.
Gorelick MH, Stevens MW, Schultz TR, Scribano PV. Performance of a Novel Clinical Score, the Paediatric Asthma Severity Score. Academic Emergency Medicine. Jan 2004;11,1: 10-18
Paediatric Normal Values Peak Expiratory Flow Rate for use with EU/EN13826 scale PEF meters only. (2004). Based on formulae in Lung Function. JE Cotes 4th Ed. 1979. Adapted for EU scale Mini-Wright peak flow meters by Clement Clarke.
European Resuscitation Council. European Life Support Course Provider Manual for use in the UK. 1ST Ed. 2004
Ni Chroinin M. Trust Guideline for the Management of Acute Wheeze/ Asthma in Infants and Children. Norfolk and Norwich University Hospital. 2005.
More on inhalers, volumatics and videos on inhaler technique from the Asthma Society of Ireland
