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Paediatrics

Asthma (Paediatrics)

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

Adapted from Paediatric Protocol 4th ed

Asthma Medications

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?

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