Body Conditions That is Accompanied by Wheezing
Wheezing is a loud high-frequency breathing sound that is heard at the end of expiration. This is due to the narrowing of the distal respiratory tract. To listen to wheezing, even in mild cases, place the ear near the child's mouth and listen to the sound of the breath when the child is calm, or use a stethoscope to listen to wheezing or crackles.
At the age of two years, wheezing is generally caused by an acute respiratory tract infection caused by a virus, such as bronchiolitis or a cough and runny nose. After two years, almost all wheezing is caused by asthma (Table 10). Sometimes children with pneumonia are accompanied by wheezing. Diagnosis of pneumonia should always be considered, especially at the age of two years.
History
- Previously there was a wheezing
- Give a response to bronchodilators
- Diagnosis of asthma or long-term asthma therapy.
Examination
- wheezing during expiration
- expiration extends
- hypersonor on percussion
- chest hyperinflation
- crackles on auscultation.
The response to bronchodilators works fast
If the cause of wheezing is unclear, or if the child breathes quickly or there is a pull in the lower chest wall in addition to wheezing, give bronchodilators work quickly and do the assessment after 20 minutes. The response to fast working bronchodilators can help determine diagnosis and therapy.
Give a fast-acting bronchodilator in one of the following ways:
- Salbutamol nebulisation
- Salbutamol with MDI (metered dose inhaler) with spacer
- If both methods are not available, give subcutaneous injection of epinephrine (adrenaline)
See response after 20 minutes. Sign of improvement:
- reduced respiratory distress (easier breathing)
- lower chest wall pull is reduced.
Children who still show signs of hypoxia (for example central cyanosis, cannot drink because of respiratory distress, pulling the lower chest wall very deep) or breathing fast, must be hospitalized.
DIAGNOSIS AND SYMPTOMS
Asthma
- Repeated wheezing history, sometimes not associated with coughs and colds
- Chest wall hyperinflation
- Longitudinal expiration
- Respond well to bronchodilators
Bronchiolitis
- The first episode wheezing for children aged <2 years
- Chest wall hyperinflation
- Longitudinal expiration
- Symptoms of pneumonia can also be found
- Poor response / no response with bronchodilators
Wheezing is related to coughs and colds
- Wheezing is always associated with coughs and colds
- There is no family history of asthma/eczema / hay fever
- Longitudinal expiration
- It tends to be lighter than wheezing due to asthma
- Respond well to bronchodilators
Strange object
- A history of sudden choking or wheezing
- Wheezing is generally unilateral
- Water trapping with hypersonor and mediastinal shift
- Sign of lung collapse
Pneumonia
- Cough with rapid breathing
- Pull the lower chest wall inward
- Fever
- Crackles
Nasal lobe breathing
