Upcoming Lectures Case Study: He is maintained on inhaled steroids, inhaled cromolyn, an orally administered leukotriene antagonist, and occasionally requires nebulized albuterol for acute episodes of wheezing. Two weeks prior to the surgery, he required one week of oral prednisone for an asthma exacerbation that was worse than usual.
Upcoming Lectures Case study: He has a history of wheezing with colds, for which he takes nebulized albuterol as needed. His last episode of wheezing with a cold was 3 weeks ago. Is there anything else you would like to know before proceeding with general anesthesia?
This will give me a better idea of the severity of his illness. I want to know about his recent health, with regard to viral illnesses, and I will ask the parents if he is exposed to cigarette smoke at home.
Children exposed to second-hand smoke tend to exhibit more airway complications during general anesthesia. Respiratory rate and pulse oximetry values should be normal. How will you induce and maintain general anesthesia in this child?
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Is it any different from a child without asthma? This child will receive premedication with oral midazolam 0. He will then undergo induction and maintenance of general anesthesia with sevoflurane by facemask throughout the entire procedure, which should last no longer than 10 minutes.
As long as this child does not demonstrate wheezing, I will not do anything differently than I would for a child without asthma. For example, prophylactic inhaled albuterol will not be administered, and no IV line is necessary. During the procedure you detect wheezing through the precordial stethoscope.
What will you do? Wheezing is a sign of bronchospasm but can also be caused by other entities. Initially, I will rule out light anesthesia and upper airway obstruction by deepening the general anesthetic while I reposition the head and neck, and suction out the oropharynx to clear any secretions.
Simultaneously, I will examine the chest, feel the ventilation bag and observe the capnography tracing, all of which can give me clues about efficacy of air entry and expiratory time. These maneuvers, in combination with deepening the anesthetic using positive-pressure ventilation, will extinguish wheezing in almost all cases without requiring bronchodilator therapy.
How will your treatment differ if the patient is tachypneic and is wheezing in the post-anesthesia care unit PACU? Wheezing in the PACU requires a different treatment strategy from the intraoperative setting. Treatment will consist of nebulized albuterol, 2.
In the majority of cases, one treatment is all that is needed for the wheezing to abate, and the child can then be observed and discharged to home if otherwise well. Reasons for hospital admission will include continuing bronchospasm that is not responding to one or two bronchodilator treatments, and a persistent oxygen requirement.
Intravenous access will be required for administration of methylprednisolone 2. If the child appears to be in pain, I will administer oral oxycodone 0.Sep 28, · The average American child spends hours staring at a computer, television, tablet, or smartphone daily according to a new study published.
Case study: Asthma (3) A month-old male is scheduled for myringotomy and tube insertions. He has a history of wheezing with colds, for which he takes nebulized albuterol as needed. Asthma Case Study: List of Adult Asthma Case Studies of Patients Treated by Dr Rajesh Shah Call Me Now US-Canada: + Others: + Over case-studies of patients for you to study.
Actual case-histories of various diseases treated at Life Force.
READ MORE. The case study represents uncontrolled brittle asthma, drug interactions and predisposing factors as respiratory tract infection that could lead to asthma morbidity in children.
The incidence of drug interactions can be 20% for patients taking 10 to 20 medications. This case describes the diagnostic dilemma presented by a patient with diabetes and a history of severe hypoglycemia. depression, and, as in this case study, Depression is a widespread disorder with the potential for chronic effects and comorbidities.
Mepolizumab in Severe Eosinophilic Asthma n engl j med ;13 ashio-midori.com 25september, S evere asthma affects less than 10% of patients with asthma .