CHILD WITH ASTHMA NOT RESPONDING TO YOUR TREATMENT
- Review your diagnosis, it might not be asthma!
- Check triggers
- Check technique
- Check compliance
- Check medication doses and choices
- Check comorbidities (especially Allergic Rhinitis, OSA, GERD, and Obesity)
- Check IgE (THINK of ABPA allergic bronchopulmonary aspergillosis!)
If you don't think it is asthma
CHILD WITH RECURRENT & NON-RESOLVING PNEUMONIA
* RECURRENT PNEUMONIA
- Two or more episodes of pneumonia in 12 months
- Three episodes altogether
- With radiological clearance in between
When to worry and investigate?
How to investigate?
Q1: Is it unilobar or multilobar?
Unilobar --> Abnormal Airway Multilobar --> Abnormal Immunity
--> Abnormal Lung --> Normal Immunity --> Primary Pulmonary Disease
--> Untreated Comorbidity
* NON-RESOLVING PNEUMONIA
Persistence of symptoms and radiological changes for 6 weeks or more despite treatment
ASTHMATIC GOING FOR SURGERY
* Review the following• Level of asthma control
• Recent exacerbations
•Medications, doses
• Hospital admissions
• Previous anesthetic history
•Cough/sputum production
• Family history of asthma
• Personal history of eczema increases the likelihood of perioperative respiratory events
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