In the past week, the Emergency Department – City Children’s Hospital, received 1 case of D. Eight-year-old TBT female, living in Vinh Hung, Long An, was hospitalized with cyanotic shortness of breath. Taking the child’s medical history recorded 2 days of illness, low fever, cough, runny nose, wheezing, shortness of breath, fatigue, treatment at a local hospital, if not reduced, they should be admitted to City Children’s Hospital. Here, the doctors noted that the child was cyanotic, showing confusion and lethargy due to severe hypoxia, blood oxygen saturation (SpO2) only 80% (normal 96-98%), shortness of breath, convulsions. Pulling the thorax, listening to the lungs has many rales, decreased lung sounds, indicating that the child’s airway is severely constricted. Arterial blood gas test showed severe respiratory acidosis, CO2 retention in the blood, pH 6.9 (normal blood pH 7.35-7.45, PaCO2: 110 mmHg (normal PaCO2: 35-). 45 mmHg), chest X-ray showed 2 pneumothorax, the child was diagnosed with severe severe asthma and received intensive asthma treatment with oxygen through a mask with a reserve bag, nebulized bronchodilator and bronchodilator. Administer salbutamol, Ipratropium 3 times in a row every 20 minutes, intravenous and nebulized corticosteroids, subcutaneous adrenaline injection for immediate bronchodilator effect, then intravenous MgSO4. The child’s progress is still severe, so nebulizer salbutamol, ipratropium, systemic corticosteroids and continuous intravenous infusion of diaphyllin, electrolyte-correcting fluids, results after nearly 3 days of treatment, the child’s condition improved, Short of breath, able to eat and drink and continue to be monitored and treated at the Department of Respiratory Medicine. asthma cases since the age of 4, but not managed locally for asthma prevention.
Through this case, we would like to remind parents of children with asthma that absolutely avoid the factors that trigger asthma attacks such as:
– Cigarette smoke
– House dust
– Room sprays, fragrance oils, insecticidal sprays, new house paint smells, etc.
– Dogs and cats
– Stuffed animals
– Bed sheets, feather blankets.
And follow-up appointments, follow the doctor’s instructions to prevent asthma attacks
Doctor of CK2 Nguyen Minh Tien
City Children’s Hospital