Acute asthma in paediatric patient

most common chronic disease of childhood leading cause of childhood morbidity of disease school absences EM presentations hospitalisations typically begins in early childhood earlier onset in males vs females Atopy with asthma in > 3years risk factors allergen specific aeroallergen (dust mite, animal dander, fungi) maternal diet during pregnancy / lactation (preventative) pollutants (tobacco smoke, biomass fuels) microbes + products psychosocial C-section higher #s than vaginal birth definition chronic inflammatory disorder of airways with assoc airway hyperresponsiveness recurrent wheeze (esp recurrent / with sleep / or with triggers - laughing or crying) breathlessness chest tightness coughing ** in DIAGNOSISdifficult to Dx younger than 5 yrs oft made on symptom patterns / clinical / FHx DDxPharmacotherapyinhaled via MDI with spacer (level A evidence for spacer) + mask if controller medicationsinhaled glucocorticoids increased lung function increased # Sx-free days reduced exacerbations / need for adn medications