Institute for Continuing Education

Pediatric Competency Part II: Pediatric Asthma

Course Objectives

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

• Describe the pathophysiology of asthma in pediatric patients across developmental stages.
• Identify genetic, environmental, and immunologic risk factors for pediatric asthma.
• Apply current NAEPP EPR-4 guidelines for asthma severity classification and control assessment.
• Perform age-appropriate physical examination and assessment techniques for pediatric asthma.
• Interpret spirometry, peak flow measurements, and fractional exhaled nitric oxide in pediatric patients.
• Implement the stepwise approach to long-term asthma pharmacotherapy.
• Recognize clinical indicators of acute asthma exacerbation severity in children.
• Execute evidence-based emergency protocols for status asthmaticus.
• Develop developmentally appropriate asthma education and self-management plans.
• Identify asthma phenotypes, comorbidities, and special populations requiring modified management.

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.