Nurse's care of acute asthma in the pediatric emergency department

Acute asthma represents 5% of visits to pediatric emergency departments. On arrival in the Emergency Department, the nurse must recognize the most seriously affected children, using a simple verbal questionnaire. Both the pediatrician and the nurse are responsible for the care and observation of the patients. The treatment plan includes nebulized beta2mimetics, administration of a corticosteroid, and oxygen when necessary. The nurse is responsible for evaluating the patient's progress and being alert for complications. She has to measure respiratory and cardiac rhythms, peak flow and transcutaneous O-2 pressure repeatedly. The child can be discharged with minimal risk of an exacerbation only if his respiratory status is fully improved and remains stable one hour after the last nebulization (more than 80% of cases). In other cases, the patient will be hospitalised in the respiratory disease unit for further treatment. (C) 2002 Editions scientitiques et medicales Elsevier SAS. All rights reserved.