EMERGENCIES ALL SHOULD KNOW:BRONCHOSPASM(WHEEZING)

BRONCHOSPASM(WHEEZING)
 Bronchospasm is a sudden constriction of the muscles in the walls of the bronchioles causing  difficulty in breathing which can be very mild to severe.

Bronchospasms are seen in Asthma, chronic bronchitis anaphylaxis etc. Bronchospasms also associated  with cold housing.Some of the things that can cause bronchospasms are consuming allergy prone foods,  getting insect bites or stings when one is allergic to them, and rarely  fluctuating hormone levels, particularly in women.

A few of the more common allergens are foods such as eggs, milk, peanuts, walnuts, tree and other nuts, fish, especially shellfish, soy and wheat; insect bites and stings, especially bee stings; and other medicines, especially penicillin and its derivatives, inhalation of pollen,dust,  animal dander,molds cigarette smoke,aerosol spray etc..

Bronchospasm is associated with narrowing of the airways and an increase in sticky mucus production not able to cough out; this reduces the amount of oxygen that is available to the individual causing breathlessness, coughing and hypoxia.Wheezing is a whistling sound that occurs during breathing, usually during expiration (breathing air out of the lungs) through narrowed airways. 

Exercise is a common trigger for wheezing in children.Psychological stress also triggers bronchospasm.Respiratory tract infections can induce bronchospasm as a part of inflammatory reaction to bacteria,virus etc.

Bete 2 agonists are treatment of choice to relieve bronchospasm.They are available as both oral medications and inhalers.To reduce the associated inflammation,steroids and cromolyn sodium are also used for speedy relief from bronchospasm.

Encourage the child to drink more water and other liquids to make the mucus thin and easy to be coughed out.I.V antibiotics are to be started in case of fever and wheezing.

A detailed history related to foreign body inhalation/ingestion is mandatory as it is easily missed out correctable cause of bronchospasm in children. If a foreign body is suspected, bronchoscopy is done to see and remove the foreign body.
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FOREIGN BODY(AIRWAY)

EPISTAXIS

HYPOGLYCEMIA

ACUTE PAIN ABDOMEN

HAEMETEMESIS

THROMBOSED,PAINFUL PILES

ACUTE TUBULAR NECROSIS

PARAPHIMOSIS

TESTICULAR TORSION

TRAUMA

RENAL COLIC

PRIAPISM

ACUTE URINE RETENSION

SEVERE PALLOR

ABSCESS

ANIMAL BITES

POISONING

BURNS

SEIZURES

PARALYTIC STROKE

ANY PREGNANCY RELATED EVENT

SUDDEN LOSS OR IMPAIRMENT OF VISION

SUDDEN HEAD ACHE AND VOMITING

HIGH GRADE FEVER

NON-RESPONSIVENESS

VIOLENT BEHAVIOUR

SUDDEN CALF PAIN

SEVERE BREATHLESSNESS