Aplicación de Normas y Protocolos de Crisis de Asma Bronquial en el Paciente Pediátrico de un establecimiento de Segundo Nivel

Abstract

Exacerbations (attacks or crisis) are acute asthma episodes or subacute characterized by progressive increase of one or more of the typical symptoms, accompanied by a decrease in expiratory flow. (4) According to WHO, asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing, which vary according to the severity and frequency. (1) In its pathogenesis involves several, partly influenced by genetic factors that causes bronchial hyperreactivity reversible either spontaneously by the drug or action cells and inflammatory mediators. (2) This case describes a male patient diagnosed with asthma 11 years 3 months in hospital indigenista; allergies not refer, presenting difficulty breathing, perform BH and send treatment with montelukast and Seretide inhaler at home does not meet treatment table 24 hours exacerbates before and apparent cause physical activity (soccer game) having difficulty breathing, shortness of breath, headache, sore throat; go to pediatric emergencies presenting tachypnea, tachycardia, saturating 79% air atmosphere, no fever, congestive oropharynx, purulent tonsils, lungs, decreased breath sounds, scattered bilateral wheezing. Diagnostic impression of asthma and tonsillitis. They perform chest X-ray, BH and PCR. 3 sprays administered salbutamol attack and methylprednisolone 50 mg IV, no improvement in symptoms; admission is decided pediatrics O2 3.5 L by mask, saturating 96%. He stayed seven days with high support O2, fogs, corticoid and antibiotic therapy from admission, made a feverish peak of 38 ° C on the first day of hospitalization, the patient's progress was steady, not weaning O2 was achieved; desaturation instantly presented with tachycardia and tachypnea, the sixth day 90-92% saturated air environment with decreased signs of respiratory distress, decreased breath sounds remained persistently mild wheezing with little gasps of left side, patient overcomes box bronchospasm.