Source: Annual Congress 2008 - Treatment and outcome of childhood asthma: new perspectives
Disease area: Paediatric lung diseases

Abstract

Asthma affects 10% of children in the United Kingdom, resulting in a high burden of care to the National Health Service (1). All severities of asthma present to paediatric services but the use of intravenous (IV) bronchodilators should be limited to those with a severe or life threatening symptoms (2). IV aminophylline is effective when used in high doses but is associated with a high incidence of adverse effects. Our institute uses IV salbutamol but a review of the literature revealed a lack of clear guidance for its prescription and use in the paediatric population.
A local audit of 12 patients has shown that confusion exists around its appropriate use and administration. Although the audit showed that 11/12 patients had severe / life threatening asthma, prescribing anomalies were present. Bolus doses were given at variable doses and over variable durations. Of the 9 patients who received an infusion, concentration and infusion regimens differed according to where they were being cared for. This related to the PICU using a different prescribing regimen.
Following the input of a multi disciplinary team, inclusive of pharmacy and ward-based staff, a clear and comprehensive algorithm for the management of acute asthma has been developed. This incorporates a guideline for the prescription and administration of IV Salbutamol. We anticipate that it‘s implementation and the planned educational programme for doctors and nurses, will minimise prescribing anomalies and improve the consistancy of future management of acute asthma in children.
1) Asthma UK. 2004
2) British Thoracic Society and Scottish Intercollegiate Guideline Network. 2007.

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Citations should be made in the following way:
S. Clayton, B. Enderby, F. Gilchrist, J. Alexander (Stoke-on-Trent, United Kingdom). The development of an algorithm for the rational use of intravenous salbutamol in severe paediatric asthma. Eur Respir J 2008; 32: Suppl. 52, 4596

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