Description
When assessing and managing cough in pediatric patients, a systematic clinical approach is essential to identify the underlying cause and provide appropriate care. Begin by obtaining a detailed history, including the onset, duration, and characteristics of the cough, as well as associated symptoms. Recognize that the causes and management of cough can vary significantly with the child's age. Evaluate the severity of the cough and its impact on the child's daily activities, sleep, and feeding. Inquire about environmental factors such as exposure to tobacco smoke, allergens, or irritants. Verify the child's immunization status, as some vaccine-preventable diseases can cause cough. Review the child's medical history, including any previous respiratory conditions, allergies, or chronic diseases.
Résumé
- Coughing in children is primarily triggered by irritants or foreign substances in the airway, activating chemo and mechanical receptors. These receptors are located throughout the airway, from the larynx to the smaller bronchi. The coughing reflex serves to protect the airway, preventing blockages and hypoxia, with a normal range of 10-25 coughs per day considered typical.
- Common causes of coughing include infections, allergies, mechanical issues, and psychogenic factors. Viral infections are particularly prevalent, while mechanical causes involve compression of the trachea. Psychogenic coughing may be a means of seeking attention, highlighting the diverse origins of the symptom.
- The coughing process involves three phases: inspiration, compression, and expiration. Triggered receptors send signals to the cough center in the brain stem, which then directs the muscles involved in the process. Infants have lower thresholds for coughing due to smaller airways and weaker expiratory muscles.
- Acute coughs are most commonly caused by viral upper respiratory infections. Chronic coughs are defined as lasting more than 21 days, with options for treatment including accp guidelines and British Thoracic Society guidelines. Clinical judgement and a cough diary can measure frequency and severity of the cough.
- Long-term productive coughs can stem from allergic rhinitis, bronchiectasis, cystic fibrosis, or tuberculosis. Management of cough involves addressing the underlying cause, such as antibiotics for bacterial infections or supportive care for viral infections. Avoid honey for infants under one year due to risk of bism.
Exemple de certificat
À propos des intervenants
Dr Vishal Parmar
Anciens élèves du Collège royal de pédiatrie et de santé infantile
Divulgation financière
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