Description

🫁 Assessment & Management of Respiratory Illness Respiratory illnesses range from mild upper respiratory tract infections (URTIs) to severe lower respiratory tract infections (LRTIs) like pneumonia, bronchiolitis, or asthma exacerbation. 🔍 1. ASSESSMENT ✅ History: Onset and duration of symptoms Type of cough: dry, wet, barking, or paroxysmal Fever, feeding difficulties, lethargy Breathing difficulties: noisy breathing, stridor, wheezing Triggers or known allergies/asthma Exposure to sick contacts or smokers ✅ Examination: Respiratory rate (age-based norms) Use of accessory muscles, nasal flaring, grunting Chest indrawing or retractions Auscultation: wheeze, crackles, decreased air entry SpO₂ (oxygen saturation) on room air General appearance: alertness, cyanosis, hydration 📋 WHO IMCI Danger Signs (Pediatric Focus): Inability to drink/breastfeed Lethargy or unconsciousness Convulsions Severe respiratory distress (e.g., chest indrawing, cyanosis) 🔬 2. CLASSIFICATION (Examples of Common Respiratory Illnesses) Illness Common Features Severity URTI (cold, pharyngitis) Runny nose, mild cough, fever Mild Croup Barking cough, inspiratory stridor Mild–severe Bronchiolitis <2 yrs, wheeze, crackles, respiratory distress Moderate–severe Pneumonia Fever, fast breathing, chest indrawing Mild to severe Asthma Recurrent wheeze, triggers, improves with bronchodilator Variable Pertussis Paroxysmal cough, post-tussive vomiting Moderate–severe 💊 3. MANAGEMENT 🟢 General Supportive Care (For Most Viral Illnesses): Antipyretics (paracetamol) Nasal saline drops/suction Adequate hydration Monitor feeding and oxygenation 🔴 When to Hospitalize: SpO₂ < 92% Moderate to severe respiratory distress Inability to feed or drink Cyanosis or altered sensorium High-risk infants (preterm, cardiac disease, immunodeficiency) 📦 Specific Management Based on Diagnosis 🔹 Bronchiolitis (Viral, infants): Supportive care only No antibiotics, bronchodilators, or steroids unless trialed and helpful Oxygen if SpO₂ < 92% 🔹 Pneumonia: Oral antibiotics (amoxicillin first-line) for mild cases IV antibiotics (ampicillin + gentamicin or ceftriaxone) for severe Oxygen, fluids, monitor closely 🔹 Asthma Exacerbation: Salbutamol via MDI + spacer or nebulizer Oral corticosteroids (e.g., prednisolone) Oxygen if needed Escalate to IV therapy or ICU if poor response 🔹 Croup: Mild: Dexamethasone (oral) Moderate–severe: Nebulized adrenaline + dexamethasone 🛑 Prevention Tips: Exclusive breastfeeding for 6 months Avoid tobacco smoke exposure Ensure routine immunizations (including Hib, pneumococcus, influenza) Handwashing and infection control Address malnutrition and anemia