caa a22 4500 477067824 CHVBK 20180405111417.0 cr unu---uuuuu 170330e19960101xx s 000 0 eng 10.1007/BF02823863 doi (NATIONALLICENCE)springer-10.1007/BF02823863 Shah M. K.E.M. Hospital, 15, Jashoda Niwas, 2nd floor, Nehru Road, Vile Parle (East), 400 057, Bombay aut Childhood asthma-office management [Elektronische Daten] [M. Shah] Childhood asthma is a major problem in office practice. For an acute life threatening attack (which is indicated by presence of severe distress, pulsus paradoxus, oxygen saturation less than 93%, cyanosis, peak expiratary flow rate of less than 50% of predicted) child should be directly admitted in intensive care unit. If it is a non life threatening attack the child can be managed in the office. Initialy, the child should be given b2 agonists by inhalation route with either metered dose inhaler (MDI), MDI with spacer or nebuliser. It there is svere bronchospasm or inhalation therapy is not possible then epineprhrine of b2 agonists may be given subcutaneously. The medications can be repeated 2-3 times. If response is adequate the child may be sent home on b2 agonist by oral or inhalantion route at an interval of 406 hours. In case of inadequate response the child is started on oral or parenteral cortieosteroids. Even after steroids if inadequate response the child is started on intravenan theophyline. Once the acute exacerbation is controlled the child is assessed for starting maintenance therapy. For this purpose his illness is graded from stage I to V depending on the severty. For stage I and II b2 agonists are prescribed as and when required. For stage III sodium cromoglycate by inhalation should be prescribed. For stage IV inhalation steroids in usual doses and for stage V inhaltion steroids in higher doses are prescribed along with a minimum dose of oral steroids is added. For sympomatic control slow release theophylline or long acting b2 agonists may be added along with maintanence therapy as and when required. Apart from medications a proper education of parents and patients is necessary to improve the outcome of asthma by increasing the compliance and better control of environment. Dr. K C Chaudhuri Foundation, 1996 Bronchial asthma nationallicence Office management nationallicence The Indian Journal of Pediatrics Springer India 63/1(1996-01-01), 37-44 0019-5456 63:1<37 1996 63 12098 https://doi.org/10.1007/BF02823863 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02823863 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Shah M. K.E.M. Hospital, 15, Jashoda Niwas, 2nd floor, Nehru Road, Vile Parle (East), 400 057, Bombay aut NATIONALLICENCE 773 0- The Indian Journal of Pediatrics Springer India 63/1(1996-01-01), 37-44 0019-5456 63:1<37 1996 63 12098 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer