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ROYAL FREE LONDON NHS FOUNDATION TRUST
PAEDIATRIC GUIDELINES
Paediatric Asthma/Wheeze Guideline
Author(s):
Richard Berg, Eli Safi, Neil Thompson
Contact author:
Shye-Wei Wong, Lynn Sinitsky
Other contributors:
Chloe Benn, Colette Dat, Benita Morrissey, UCLP Asthma Network
Previous authors:
Rahul Chodhari
Related guidelines or documents:
2016 BTS/SIGN Guideline for the management of asthma
NICE quality standard QS25
Approved by:
The Paediatric Guidelines Group on behalf of the Women, Children and Imaging Services Division
Issue no (Version):
November 2016 (version no. 1.0)
File name:
Paediatric Asthma_Wheeze Guideline
Key words: (up to 10)
Paediatric Asthma Wheeze
Supercedes:
Asthma guideline 06/09/2006
Significant change in practice:
Use of magnesium IV bolus prior to salbutamol bolus
Patients should receive a personalized asthma plan prior to discharge
Implementation plan:
Dissemination of the guideline via the intranet, guideline events and department meetings
Monitoring via clinical audit via the local audit programme
Service Line Lead
Paediatrics: Rahul Chodhari
Clinical Director for Paediatrics
Tim Wickham
Divisional Director of Nursing
Mai Buckley
For Review:
May 2017 or in response to practice developments
Contents
Introduction4
SECTION A: MANAGEMENT OF CHILD WITH ACUTE WHEEZE/ASTHMA5
Assessment of acute wheeze/asthma5
1.History5
2.Examination5
3.Assessing severity6
4.Investigations7
Ensuring the correct diagnosis8
Wheeze in the preschool child9
Young people and adolescents9
Difficult Asthma10
Acute wheeze flowchart for children 2-16 years11
The deteriorating child with wheeze/asthma12
Medications for acute wheeze/asthma13
SECTION B: MEDICATION13
Weaning bronchodilators15
Preventer therapy for children >5 years16
Preventer therapy for children 94% in air
>92% air