Management of acute episodes in young children in the community

The assessment of acute asthma in children under five can be difficult

• viral infections are usually responsible for intermittent wheezing attacks
• furthermore, response to asthma medication may be inconsistent

Differential diagnosis of symptoms includes:

• aspiration pneumonitis
• pneumonia
• bronchiolitis
• tracheomalacia
• complications of underlying conditions such as congenital anomalies and cystic fibrosis

The first decision point in the management is whether the child is <2 years, 2-5 years old or > 5 years.

• management of acute asthma in children under 1 year should be under the direction of a respiratory paediatrician

Reference:

1. British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) 2019. British Guideline on the Management of Asthma. A national clinical guideline.