Abstract

KLING, S  and  WHITE, D A. Management of asthma exacerbations in children. SAMJ, S. Afr. med. j. [online]. 2021, vol.111, n.8, pp.710-713. ISSN 2078-5135.  http://dx.doi.org/10.7196/samj.2021.v111i5.15853.

Asthma exacerbations are episodes of worsening asthma symptoms with shortness of breath, cough, wheeze and/or tight chest that require an increase in asthma treatment. A major change in the recommendations for managing mild asthma exacerbations is the move away from using inhaled short-acting beta-2 agonists (SABAs) as the sole reliever, toward a combination of a rapid-onset, long-acting beta-2 agonist, formoterol, in combination with an inhaled corticosteroid (ICS), or a SABA used together with an ICS in separate inhalers, in older children and adolescents. In children <11 years of age who are adherent to daily ICS treatment, the ICS dose should not be increased short term. A written asthma plan should include instructions on how to self-manage asthma exacerbations, and when to present to a medical facility. Oxygen is an essential component of the management of asthma exacerbations at both primary care and emergency department facilities, together with inhaled SABAs via metered-dose inhaler and spacer, and oral corticosteroids.

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