Last Updated on February 5, 2023
Evaluation of background of newly diagnosed asthma
Asthma control
Severity of AEBA
How to write diagnosis?
Severity of AEBA + underlying cause for current AEBA ± background of asthma ± control of asthma
Example 1
Severe AEBA secondary to bronchopneumonia with underlying mild persistent asthma (poorly controlled)
Example 2
Moderate AEBA secondary to URTI with underlying newly diagnosed intermittent asthma
Management of AEBA
Asthma Medications
- Nebulized medications
- Corticosteroids
- IV Hydrocortisone
- T Prednisolone 1 mg/kg/day (max 60 mg/day) for 3 – 5 days
Preparation for discharge
• Asthma education e.g.
– Understanding of asthma in childhood
– Assessment of inhaler technique
– Compliance to controller (e.g. MDI Budesonide)
– How to take care of aerochamber
– How to check metered-dose inhaler prior to using
– Avoidance of related triggering factor e.g. smoking cessation, avoid cold drinks etc.
• Asthma action plan
• Asthma / Cough diary
• Follow-up (e.g. in outpatient paediatric clinic / in Klinik Kesihatan) & date
• Caretaker to buy aerochamber
Asthma diary // Cough diary
Educate caretaker on daily assessment of child’s condition:
– Presence of asthma symptoms: daytime cough, nocturnal cough, wheezing / chest tightness
– Whether requiring reliever
– Whether requiring visit to clinic / hospital for nebuliser
– Whether compliant to controller
View / Download an example of asthma diary here
Caretaker needs to bring this asthma diary / cough diary during Paediatric outpatient clinic appointment for evaluation of asthma control
Asthma action plan
Aim: to prevent / terminate asthma
Including:
• How to recognise worsening asthma
• How to treat worsening asthma
• How and when to seek medical attention
Miscellaneous
• Plot growth chart to look for any evidence of faltering growth
• Was reliever (e.g. MDI Salbutamol) instead of controller (e.g. MDI Budesonide) mistakenly given daily?