Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions

Family Medicine

Answer 4
  1. If the child responds poorly to initial therapy and requires admission, ipratropium should be continued in the inpatient setting. Although inhaled ipratropium has been demonstrated to be beneficial in the ED setting, the NHLBI guidelines1 reviewed 2 studies in children that have failed to demonstrate any benefit of adding ipratropium once the patient is hospitalized. Children with a pulse oximetry reading below 92% to 94% often require hospitalization.1 Children younger than 5 years are generally unable to perform spirometry or peak flow testing. Infants have a higher risk of respiratory failure, and their response to inhaled ß2-agonist therapy is more unpredictable, so careful monitoring is essential.

    1. National Asthma Education and Prevention Program. Expert panel report 3: guidelines for the diagnosis and management of asthma (EPR-3 2007). NIH Publication No. 08–4051. Bethesda (MD): U.S. Department of Health and Human Services; National Institutes of Health; National Heart, Lung, and Blood Institute; 2007. Available at www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm. Accessed 22 Jul 2008.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 9/22/08 • nvf