eMedicine Specialties > Emergency Medicine > Pediatric

Pediatrics, Reactive Airway Disease: Multimedia

Author: Eric S Chin, MD, Consulting Staff, Department of Emergency Medicine, Kaiser Permanente Hospital, South San Francisco
Contributor Information and Disclosures

Updated: Jun 30, 2009

Multimedia

Patient peak flow record.
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Media file 1: Patient peak flow record.
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Patient peak flow record.

Patient peak flow record.

This nomogram results from tests carried out by S...
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Media file 2: This nomogram results from tests carried out by S. Godfrey, MD, and his colleagues on a sample of 382 healthy boys and girls aged 5-18 years. Each child blew 5 times into a standard Wright Peak Flow Meter, and the highest reading was accepted in each case. All measurements were completed within a 6-week period. The outer lines of the graph indicated that the results of 95% of the children fell within these boundaries.
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This nomogram results from tests carried out by S...

This nomogram results from tests carried out by S. Godfrey, MD, and his colleagues on a sample of 382 healthy boys and girls aged 5-18 years. Each child blew 5 times into a standard Wright Peak Flow Meter, and the highest reading was accepted in each case. All measurements were completed within a 6-week period. The outer lines of the graph indicated that the results of 95% of the children fell within these boundaries.

Stepwise approach for managing asthma in children...
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Media file 3: Stepwise approach for managing asthma in children 0 to 4 years of age. National Institutes of Health. National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the diagnosis and management of asthma. August 2007. NIH publication no. 07-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/index.htm. 3 Accessed December 30, 2007. PRN, As necessary.
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Stepwise approach for managing asthma in children...

Stepwise approach for managing asthma in children 0 to 4 years of age. National Institutes of Health. National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the diagnosis and management of asthma. August 2007. NIH publication no. 07-4051. Available at: http://www.nhlbi.nih.gov/guidelines/asthma/index.htm. 3 Accessed December 30, 2007. PRN, As necessary.

More on Pediatrics, Reactive Airway Disease

Overview: Pediatrics, Reactive Airway Disease
Differential Diagnoses & Workup: Pediatrics, Reactive Airway Disease
Treatment & Medication: Pediatrics, Reactive Airway Disease
Follow-up: Pediatrics, Reactive Airway Disease
Multimedia: Pediatrics, Reactive Airway Disease
References
Further Reading
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References

  1. [Guideline] Reddel HK, Taylor DR, Bateman ED, et al. An official American Thoracic Society/european Respiratory Society statement: asthma control and exacerbations: standardizing endpoints for clinical asthma trials and clinical practice. Am J Respir Crit Care Med. Jul 1 2009;180(1):59-99. [Medline].

  2. Szefler SJ. Advances in pediatric asthma in 2007. J Allergy Clin Immunol. Mar 2008;121(3):614-9. [Medline].

  3. Rosenstreich DL, Eggleston P, Kattan M, et al. The role of cockroach allergy and exposure to cockroach allergen in causing morbidity among inner-city children with asthma. N Engl J Med. May 8 1997;336(19):1356-63. [Medline].

  4. Litonjua AA, Carey VJ, Burge HA, et al. Exposure to cockroach allergen in the home is associated with incident doctor-diagnosed asthma and recurrent wheezing. J Allergy Clin Immunol. Jan 2001;107(1):41-7. [Medline].

  5. Castro-Rodríguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. Oct 2000;162(4 Pt 1):1403-6. [Medline]. [Full Text].

  6. Kim KW, Shin YH, Lee KE, Kim ES, Sohn MH, Kim KE. Relationship between adipokines and manifestations of childhood asthma. Pediatr Allergy Immunol. Sep 2008;19(6):535-40. [Medline].

  7. Federico MJ, Wamboldt FS, Carter R, Mansell A, Wamboldt MZ. History of serious asthma exacerbations should be included in guidelines of asthma severity. J Allergy Clin Immunol. Jan 2007;119(1):50-6. [Medline].

  8. Stewart LJ. Pediatric asthma. Prim Care. Mar 2008;35(1):25-40, vi. [Medline].

  9. Hederos CA, Janson S, Andersson H, Hedlin G. Chest X-ray investigation in newly discovered asthma. Pediatr Allergy Immunol. Apr 2004;15(2):163-5. [Medline].

  10. Hsu KH, Jenkins DE, Hsi BP, et al. Ventilatory functions of normal children and young adults--Mexican- American, white, and black. II. Wright peak flowmeter. J Pediatr. Aug 1979;95(2):192-6. [Medline].

  11. [Best Evidence] Sorkness CA, Lemanske RF Jr, Mauger DT, Boehmer SJ, Chinchilli VM, Martinez FD, et al. Long-term comparison of 3 controller regimens for mild-moderate persistent childhood asthma: the Pediatric Asthma Controller Trial. J Allergy Clin Immunol. Jan 2007;119(1):64-72. [Medline].

  12. Blackhall K, Appleton S, Cates CJ. Ionisers for chronic asthma. Cochrane Database Syst Rev. 2003;CD002986. [Medline]. [Full Text].

  13. Amirav I, Newhouse MT. Metered-dose inhaler accessory devices in acute asthma: efficacy and comparison with nebulizers: a literature review. Arch Pediatr Adolesc Med. Sep 1997;151(9):876-82. [Medline].

  14. Apter AJ, Szefler SJ. Advances in adult and pediatric asthma. J Allergy Clin Immunol. Mar 2004;113(3):407-14. [Medline].

  15. Baren JM, Zorc JJ. Contemporary approach to the emergency department management of pediatric asthma. Emerg Med Clin North Am. Feb 2002;20(1):115-38. [Medline].

  16. Beasley R, Crane J, Lai CK, Pearce N. Prevalence and etiology of asthma. J Allergy Clin Immunol. Feb 2000;105(2 Pt 2):S466-72. [Medline].

  17. Becker A, Watson W, Ferguson A, et al. The Canadian asthma primary prevention study: outcomes at 2 years of age. J Allergy Clin Immunol. Apr 2004;113(4):650-6. [Medline].

  18. Clainche LL, Timsit S, Rigourd V, et al. Asthma and the child below 5 years of age: diagnosis and treatment [in French]. Rev Mal Respir. Feb 2000;17(1 Pt 2):213-23. [Medline].

  19. Craig VL, Bigos D, Brilli RJ. Efficacy and safety of continuous albuterol nebulization in children with severe status asthmaticus. Pediatr Emerg Care. Feb 1996;12(1):1-5. [Medline].

  20. Crain EF, Mortimer KM, Bauman LJ, et al. Pediatric asthma care in the emergency department: measuring the quality of history-taking and discharge planning. J Asthma. 1999;36(1):129-38. [Medline].

  21. Csonka P, Mertsola J, Klaukka T, et al. Corticosteroid therapy and need for hospital care in wheezing preschool children. Eur J Clin Pharmacol. Nov 2000;56(8):591-6. [Medline].

  22. Darr CD. Asthma and bronchiolitis. In: Emergency Medicine: Concepts and Clinical Practice. 4th ed. 1998:1137-45.

  23. Eggleston PA, Wood RA, Rand C, et al. Removal of cockroach allergen from inner-city homes. J Allergy Clin Immunol. Oct 1999;104(4 Pt 1):842-6. [Medline].

  24. [Guideline] Expert panel commissioned by the National Asthma Education and Prevention Program (NAEPP) Coordinating Committee(CC), coordinated by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. The Expert Panel Report 3 (EPR–3) Full Report 2007: Guidelines for the Diagnosis and Management of Asthma. August 28, 2007;[Full Text].

  25. Farber HJ, Johnson C, Beckerman RC. Young inner-city children visiting the emergency room (ER) for asthma: risk factors and chronic care behaviors. J Asthma. 1998;35(7):547-52. [Medline].

  26. Garde Garde Jf, Haro E, Sanchez-Lucas C, Garde Noguera J. Antileukotrienes. Their use in pediatrics [in Spanish]. Allergol Immunopathol (Madr). May-Jun 2000;28(3):136-43. [Medline].

  27. Gibbs MA, Camargo CA, Rowe BH, Silverman RA. State of the art: therapeutic controversies in severe acute asthma. Acad Emerg Med. Jul 2000;7(7):800-15. [Medline].

  28. [Best Evidence] Guilbert TW, Morgan WJ, Zeiger RS, Mauger DT, Boehmer SJ, Szefler SJ, et al. Long-term inhaled corticosteroids in preschool children at high risk for asthma. N Engl J Med. May 11 2006;354(19):1985-97. [Medline]. [Full Text].

  29. [Best Evidence] Hondras MA, Linde K, Jones AP. Manual therapy for asthma. Cochrane Database Syst Rev. Apr 18 2005;CD001002. [Medline]. [Full Text].

  30. Kellner JD, Ohlsson A, Gadomski AM, Wang EE. Efficacy of bronchodilator therapy in bronchiolitis. A meta-analysis. Arch Pediatr Adolesc Med. Nov 1996;150(11):1166-72. [Medline].

  31. Kemp JP, Dockhorn RJ, Shapiro GG, et al. Montelukast once daily inhibits exercise-induced bronchoconstriction in 6- to 14-year-old children with asthma. J Pediatr. Sep 1998;133(3):424-8. [Medline].

  32. Kitch BT, Chew G, Burge HA, et al. Socioeconomic predictors of high allergen levels in homes in the greater Boston area. Environ Health Perspect. Apr 2000;108(4):301-7. [Medline].

  33. Le Clainche L, Timsit S, Rigourd V, et al. Asthma in children below 5 years of age: diagnosis and treatment. Rev Mal Respir. Feb 1999;16(1):17-27. [Medline].

  34. Newson T, McKenzie S. Cough and asthma in children. Pediatr Ann. Mar 1996;25(3):156-8, 161. [Medline].

  35. Qureshi F, Zaritsky A, Lakkis H. Efficacy of nebulized ipratropium in severely asthmatic children. Ann Emerg Med. Feb 1997;29(2):205-11. [Medline].

  36. Roback MG, Dreitlein DA. Chest radiograph in the evaluation of first time wheezing episodes: review of current clinical practice and efficacy. Pediatr Emerg Care. Jun 1998;14(3):181-4. [Medline].

  37. Rubin BK, Albers GM. Use of anticholinergic bronchodilation in children. Am J Med. Jan 29 1996;100(1A):49S-53S. [Medline].

  38. Rudolph CD. Supraesophageal complications of gastroesophageal reflux in children: challenges in diagnosis and treatment. Am J Med. Aug 18 2003;115 Suppl 3A:150S-156S. [Medline].

  39. Schreck DM, Babin S. Comparison of racemic albuterol and levalbuterol in the treatment of acute asthma in the ED. Am J Emerg Med. Nov 2005;23(7):842-7. [Medline].

  40. Schuh S, Reisman J, Alshehri M, et al. A comparison of inhaled fluticasone and oral prednisone for children with severe acute asthma. N Engl J Med. Sep 7 2000;343(10):689-94. [Medline].

  41. Spahn JD. Pharmacologic management of pediatric asthma. 1998;18 (1):165-81.

  42. Stempel DA, Meyer JW, Stanford RH, Yancey SW. One-year claims analysis comparing inhaled fluticasone propionate with zafirlukast for the treatment of asthma. J Allergy Clin Immunol. Jan 2001;107(1):94-8. [Medline].

  43. Steyer TE, Mallin R, Blair M. Pediatric asthma. Clinics in Family Practice. Jun 2003;5.

  44. Suissa S, Ernst P, Benayoun S, et al. Low-dose inhaled corticosteroids and the prevention of death from asthma. N Engl J Med. Aug 3 2000;343(5):332-6. [Medline].

  45. Sun HL, Chou MC, Lue KH, et al. The relationship of air pollution to ED visits for asthma differ between children and adults. Am J Emerg Med. Oct 2006;24(6):709-13. [Medline].

  46. Walsh-Kelly CM, Kim MK, Hennes HM. Chest radiography in the initial episode of bronchospasm in children: can clinical variables predict pathologic findings?. Ann Emerg Med. Oct 1996;28(4):391-5. [Medline].

  47. Welliver RC. Immunologic mechanisms of virus-induced wheezing and asthma. J Pediatr. Aug 1999;135(2 Pt 2):14-20. [Medline].

  48. Werk LN, Steinbach S, Adams WG, Bauchner H. Beliefs about diagnosing asthma in young children. Pediatrics. Mar 2000;105(3 Pt 1):585-90. [Medline].

  49. Williams JR, Bothner JP, Swanton RD. Delivery of albuterol in a pediatric emergency department. Pediatr Emerg Care. Aug 1996;12(4):263-7. [Medline].

  50. Wohl ME, Majzoub JA. Asthma, steroids, and growth. N Engl J Med. Oct 12 2000;343(15):1113-4. [Medline]. [Full Text].

  51. Wolfram RW. Asthma. In: The Clinical Practice of Emergency Medicine. 2nd ed. 1997:1093-96.

  52. Zeffren BS, Windom HH, Bahna SL. Modern Treatment of Asthma in Children. Vol 43. Mosby Year Book; 1996:423-68.

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Further Reading

Clinical guidelines

 Managing asthma long term in children 0-4 years of age and 5-11 years of age. In: National Asthma Education and Prevention Program (NAEPP). Expert panel report 3: guidelines for the diagnosis and management of asthma. Bethesda (MD): National Heart, Lung, and Blood Institute; 2007 Aug. p. 281-325.

Global Initiative for Asthma (GINA), National Heart, Lung and Blood Institute (NHLBI). Global strategy for asthma management and prevention. Bethesda (MD): Global Initiative for Asthma (GINA), National Heart, Lung and Blood Institute (NHLBI); 2007. 92 p.

Managing exacerbations of asthma. In: National Asthma Education and Prevention Program (NAEPP). Expert panel report 3: guidelines for the diagnosis and management of asthma. Bethesda (MD): National Heart, Lung, and Blood Institute; 2007 Aug. p. 373-417.

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Keywords

reactive airway disease in children, asthma, pediatric asthma, exercise induced asthma, exercise-induced asthma, asthma treatment, asthma assessment, asthma symptoms, asthma triggers, asthma causes, bronchospasm, obstructive airway disease, childhood asthma, hypersensitivity reaction, wheeze, wheezing, RAD, airway inflammation, upper respiratory infection, tachypnea, dyspnea, cyanosis, intercostal retractions, nasalpolyps, nasal secretions, diaphoresis, hyperresonance, pulsus paradoxus, decreased peak expiratory flow rate, pectus carinatum, clubbing, subcutaneous emphysema, respiratory syncytial virus infection, RSV infection, Mycoplasma pneumoniae, pet dander, cockroach allergen, dust mite allergen, molds, pollen, weather changes, bronchiolitis, gastroesophageal fistula, cystic fibrosis

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Contributor Information and Disclosures

Author

Eric S Chin, MD, Consulting Staff, Department of Emergency Medicine, Kaiser Permanente Hospital, South San Francisco
Disclosure: Nothing to disclose.

Medical Editor

Debra Slapper, MD, Consulting Staff, Department of Emergency Medicine, St Anthony's Hospital
Debra Slapper, MD is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Grace M Young, MD, Associate Professor, Department of Pediatrics, University of Maryland Medical Center
Grace M Young, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Emergency Physicians
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Richard G Bachur, MD, Associate Professor of Pediatrics, Harvard Medical School; Associate Chief and Fellowship Director, Attending Physician, Division of Emergency Medicine, Children's Hospital of Boston
Richard G Bachur, MD is a member of the following medical societies: American Academy of Pediatrics, Society for Academic Emergency Medicine, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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