Chronic airway inflammation with reversible obstruction, presenting with recurrent wheeze, cough and breathlessness in children.
Investigations
- • Clinical pattern plus trial of therapy under 5 years
- • Spirometry with bronchodilator reversibility ≥12% if ≥5 years
- • FeNO where available; allergy testing
Management
- • Acute: burst salbutamol 10 puffs via spacer, oral prednisolone 1–2 mg/kg × 3 days
- • Severe: nebulised salbutamol + ipratropium, IV magnesium 40 mg/kg
- • Maintenance: low-dose ICS, step up per GINA with inhaler-technique review
- • Written asthma action plan and school supply
Clinical pearls
- • A silent chest is pre-terminal — escalate immediately
- • Most 'treatment failure' is poor adherence or inhaler technique
Related in WardRound
Educational — verify locally.
