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Asthma, Pediatric

Asthma, Pediatric is a topic covered in the 5-Minute Emergency Consult.

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  • 2.7 million children (<18 yr) affected in US
  • 850,000 ED visits per year in US
  • Inflammatory events, usually viral, lead to bronchoconstriction:
    • Compounded by hyper-reactivity of airways
    • Mediators of the inflammatory cascade exacerbate symptoms
  • Airway obstruction produces increased airway resistance and gas trapping:
    • Mucosal edema
    • Bronchospasm
    • Mucous plugging
  • Infants more vulnerable to respiratory failure:
    • Increased peripheral resistance
    • Decreased elastic recoil with early airway closure
    • Unstable rib cage
    • Mechanically disadvantaged diaphragm
  • Family history of allergy
  • Medical history of early injury to airway (bronchopulmonary dysplasia, pneumonia, intubation, croup, reflux, passive exposure to smoking), reactions to foods and drugs, other allergic manifestations
  • Environmental exposures such as pets, smoke, carpets, or dust may trigger or exacerbate


Precipitating/Aggravating Factors
  • Infection:
    • Viral
    • Bacterial
  • Allergic/irritant:
    • Environment: Pollens, grasses, mold, house dust mites, and animal dander
    • Occupational chemicals: Chlorine, ammonia—food and additives
    • Irritants: Smoke, pollutants, gases, and aerosols
    • Exercise
    • Cold weather
    • Emotional: Stress, phobia
    • Intoxication: β-blockers, aspirin, NSAIDs

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Rosen, Peter, et al., editors. "Asthma, Pediatric." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307595/all/Asthma__Pediatric.
Asthma, Pediatric. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307595/all/Asthma__Pediatric. Accessed April 23, 2019.
Asthma, Pediatric. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307595/all/Asthma__Pediatric
Asthma, Pediatric [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 23]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307595/all/Asthma__Pediatric.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Asthma, Pediatric ID - 307595 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307595/all/Asthma__Pediatric PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -