TY - CHAP M1 - Book, Section TI - Asthma A1 - O'Sullivan, Ronan A1 - O'Donnell, Sinead M. A1 - Brown, Kathleen M. A2 - Schafermeyer, Robert A2 - Tenenbein, Milton A2 - Macias, Charles G. A2 - Sharieff, Ghazala Q. A2 - Yamamoto, Loren G. PY - 2014 T2 - Strange and Schafermeyer's Pediatric Emergency Medicine, 4e AB - Asthma is the most common chronic disease of childhood and is associated with significant morbidity and mortality.It is now defined as ‘a common chronic disorder of the airways that is complex and characterized by variable and recurring symptoms, airflow obstruction, bronchial hyperresponsiveness, and an underlying inflammation'There is emerging evidence that pre-school wheezers should be treated differently to classic atopic wheezing in older children.Inhaled albuterol remains the first line therapy for acute asthmatic exacerbations. Delivery of albuterol by metered dose inhaler and spacer device has been shown to be superior to delivery by nebulization.The addition of ipratroprium to the first two to three albuterol doses has been associated with a decreased need for hospitalization in pediatric patients with moderate-to-severe asthma exacerbations.Early administration of oral corticosteroids in the emergency department has been shown to enhance recovery from an acute asthma exacerbation and decrease rates of hospitalization.Oral dexamethasone (one–two doses) has been shown to be as efficacious as a 5-day course of oral prednisone.Magnesium sulfate is of benefit in patients with moderate-to-severe exacerbations who do not respond to initial bronchodilator therapy, and should be the first-line parenteral bronchodilator in severe/critical asthma.Asthma education, including asthma action plans on ED discharge, provided to children and their parents while in the ED results in fewer future ED visits and hospital admissions. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1105681929 ER -