Institute for Continuing Education

Pediatric Competency Part II: Pediatric Asthma

Course Objectives

Upon successful completion of this module, you will be able to:

• List the common clinical parameters for determining perfusion in the pediatric patient.
• Identify a systematic approach for obtaining blood and intravenous access.
• Describe the therapeutic approach for treating moderate to severe croup.
• Identify some of the common non-respiratory causes of grunting respirations.
• Illustrate a quick mnemonic used for a differential of the critically ill pediatric patient.
• Describe the management of the child with status seizures and no intravenous access.
• List the factors used in identification of the age of bruises in the pediatric patient.
• Define crucial physical examination criteria for moderate to severe pediatric asthma.
• State the function of pulmonary testing in acute pediatric asthma.
• Elucidate the appropriate clinical decision making in caring for the crashing pediatric asthma patient.

Course Information

Most children with asthma can lead healthy, active lives. Learn how self-monitoring, avoiding triggers, and concentrating on long-term control can work for your patients.

The recent release of updated guidelines on the diagnosis and management of asthma makes this an appropriate time to take a fresh look at this chronic lung disease. The new guidelines underscore the role of inflammation in asthma and emphasize the suppression of inflammation as a therapeutic goal. They also revise the asthma severity classifications used to choose a regimen, with corresponding changes in the recommended stepwise therapy.

Asthma manifests itself in a range of symptoms that may include wheeze, cough, shortness of breath, reduced expiratory flow, exercise intolerance, and respiratory distress. Recognizable triggers such as allergens or infections usually precipitate symptoms. Even before symptoms become apparent, however, the airways become inflamed and mucus production increases. These changes combine to limit airflow to and from the alveoli. For that reason, managing inflammation and its symptoms, not just reducing bronchospasm or suppressing coughs, is the foundation of effective asthma management.

Treatment begins with minimizing exposure to triggers and preventive therapy such as influenza vaccine. Frequent monitoring of symptoms is essential to good control. Children with persistent moderate or severe asthma need daily monitoring with a symptom diary and, for children who are old enough, daily peak flow readings. With proper management, most children with chronic asthma can sleep comfortably, grow to their full potential, and function as well as their unaffected peers.