Asthma is the most common chronic disease of childhood. Although home action plans and the use of maintenance medications have improved daily management and control of asthma, many children still require emergency department care at least once per year.
Our recent issue Emergency Department Management of Pediatric Acute Asthma: An Evidence-Based Review reviews the current evidence-based emergency department management recommendations for moderate to severe acute asthma in pediatric patients.
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Here are a few key points:
- Not every patient who wheezes has asthma. Consider other etiologies such as pneumonia, foreign body aspiration, anaphylaxis, and congestive heart failure. (See Table 1 in the issue.)
- Routine use of blood gases is no longer recommended. Use of pulse oximetry and end-tidal CO2 are much more reliable and less invasive.
- Radiography is no longer routinely recommended for first-time wheezers, but chest x-rays should be considered in patients who have suspected pneumonia, pneumothorax, or foreign body aspiration.
- First-line therapy for pediatric acute asthma includes inhaled bronchodilators and corticosteroids in the first hour of ED stay.
Read the full issue and earn 4 CME credits