This is not a complete note or a guide. This was prepared by me based on the teachings of Dr.R.M.Mudiyanse just to aid the short cases.

1. Why persistent?
Nearby spacer/MDI/ DPI
3. Pleural effusion with some respiratory
distress probably a child who is
recovering from DHF.
Why recovering from DHF?
Recovery rash, flushing, 2
cannula either side
Why respiratory distress?
Tachypnea. So COUNT RR/HR
Respiration short cases
BA
Bronchiolitis
PE
Bronchiectasis
1.
2.
3.
4.
Pathology
Severity
Acute/chronic
Complications: FTT/ HF
Pathology
1. Upper airway: stridor
2. Lower airway: U/L or B/L diffuse or
localized
3. Pleural effusion
4. Systemic: Pleural effusion in DHF pt
who is recovering (NOT just dengue
fever)
Emphysematous chest,
B/L rhonchi,
Eczema → BA
If clubbing + → can’t be BA. May be
bronchiectasis/ chr lung Dx
Features of hyperinflation (→bronchiolitis)
1. Barrel shaped chest
2. Hyper-resonant over the liver
3. Hyper-resonant over the heart
Severity: Effort, Efficacy, Effects
Effort
1. Recessions
2. Respiratory rate
3. Stridor
4. Grunting
5. Accessory muscles use
6. Flare of Alea nasi
Efficacy
1. Air entry – silent chest is a dangerous
sign.
2. Chest expansion
3. Cyanosis, hypoxia (pulse oxymeter,
92%)
Effects
1. CNS -Drowsy, agitation
2. CVS – Pallor, bradycardia, tachycardia.
Why do you say this is severe asthma?
Comprehensive diagnosis-e.g.
1. Moderately severe bronchiolitis in a
child with FTT.
2. BA with mild distress in a child
probably with persistent asthma who
has an eczema as well.
Yapa Wijeratne