Respiratory Physiotherapy in Paediatric Patients With Pneumonia: Difference between revisions
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Pneumonia is a leading cause of morbidity and mortality in children younger than the age of 5 years worldwide. Annually, there are an estimated 120 million cases of pneumonia worldwide, resulting in as many as 1.3 million deaths. Younger children under the age of 2 in the developing world, account for nearly 80% of pediatric deaths secondary to pneumonia. <ref>Ebeledike C, Ahmad T. [https://www.ncbi.nlm.nih.gov/books/NBK536940/ Pediatric Pneumonia.] InStatPearls [Internet] 2020 Jan 6. StatPearls Publishing.</ref> | Pneumonia is a leading cause of morbidity and mortality in children younger than the age of 5 years worldwide. Annually, there are an estimated 120 million cases of pneumonia worldwide, resulting in as many as 1.3 million deaths. Younger children under the age of 2 in the developing world, account for nearly 80% of pediatric deaths secondary to pneumonia. <ref>Ebeledike C, Ahmad T. [https://www.ncbi.nlm.nih.gov/books/NBK536940/ Pediatric Pneumonia.] InStatPearls [Internet] 2020 Jan 6. StatPearls Publishing.</ref> | ||
The etiology of pneumonia in the pediatric population can be classified by age-specific versus pathogen-specific organisms. neonates are more prone to have bacterial pneumonia | The etiology of pneumonia in the pediatric population can be classified by age-specific versus pathogen-specific organisms. neonates are more prone to have bacterial pneumonia whereas viral pneumonia is more common in toddlers. Community-acquired pneumonia ( CAP) is common among children globally, but incidence and mortality rates are significantly higher in low‐income countries. The factors for increasing incidence and mortality rates in developing countries include prematurity, malnutrition, low socioeconomic status, exposure to tobacco smoke, and child care attendance.<ref>Stuckey-Schrock K, Hayes BL, George CM. [https://www.aafp.org/afp/2012/1001/p661.pdf Community-acquired pneumonia in childre]n. American family physician. 2012 Oct 1;86(7):661-7.</ref><br> | ||
=== Medical Intervention === | === Medical Intervention === | ||
The original guidelines by WHO classified the severity of illness using simple clinical signs of children 2 to 59 months of age into four categories: | |||
# Children with cough and cold who did not have signs of pneumonia were classified as “no pneumonia”, and their caregivers were advised on appropriate home care. | |||
# Children with fast breathing were classified as “pneumonia” and were given an oral antibiotic (cotrimoxazole/ amoxicillin-at least 40 mg/kg/dose twice daily or 80mg/kg/day) to take at home for five days. | |||
# Children who had chest indrawing with or without fast breathing were classified as “severe pneumonia” and were referred to the closest health facility for treatment with injectable penicillin. | |||
# Children who had any general danger signs (Not able to drink, persistent vomiting, convulsions, lethargic or unconscious, stridor in a calm child or severe malnutrition) were classified as “severe pneumonia or very severe disease”. These children received the first dose of oral antibiotics and were then urgently referred to a health facility for further evaluation and treatment with parenteral antibiotics. | |||
Supportive and symptomatic management is key and includes supplemental oxygen for hypoxia, antipyretics for fever, and fluids for dehydration. This is especially important for non-infectious pneumonitis and viral pneumonia for which antibiotics are not indicated. Cough suppressants are not recommended. | |||
== Description of the Intervention == | == Description of the Intervention == | ||
Chest physiotherapy is the vital adjuvant treatment of most respiratory illnesses, and is used for children with chronic respiratory or neuromuscular disease | |||
== Aim of Chest Physiotherapy == | == Aim of Chest Physiotherapy == | ||
Revision as of 11:01, 16 July 2020
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Description of the Condition[edit | edit source]
Introduction[edit | edit source]
Pneumonia is the type of lung infection which is caused by bacteria, viruses, and fungi.
- These foreign microbes are responsible for inflammation of the lungs causing fluid collection in the alveoli and thus hamper the ventilation-perfusion ratio.
- As a protective mechanism, the accumulation of secretions in the airways occurs which worsens clinical symptoms and leads to an increase in airway resistance with each breath.
These signs and symptoms of Pneumonia (fever, tachypnoea, nasal flaring, cough, breathlessness, lower chest wall indrawing, and reduced oxygen saturation) are useful in diagnosing pneumonia. Chest assessment also helps to determine the diagnosis and prognosis of the disease. Chest radiographic images are the gold standard for diagnoses of pneumonia.[1]
Epidemiology[edit | edit source]
Pneumonia is a leading cause of morbidity and mortality in children younger than the age of 5 years worldwide. Annually, there are an estimated 120 million cases of pneumonia worldwide, resulting in as many as 1.3 million deaths. Younger children under the age of 2 in the developing world, account for nearly 80% of pediatric deaths secondary to pneumonia. [2]
The etiology of pneumonia in the pediatric population can be classified by age-specific versus pathogen-specific organisms. neonates are more prone to have bacterial pneumonia whereas viral pneumonia is more common in toddlers. Community-acquired pneumonia ( CAP) is common among children globally, but incidence and mortality rates are significantly higher in low‐income countries. The factors for increasing incidence and mortality rates in developing countries include prematurity, malnutrition, low socioeconomic status, exposure to tobacco smoke, and child care attendance.[3]
Medical Intervention[edit | edit source]
The original guidelines by WHO classified the severity of illness using simple clinical signs of children 2 to 59 months of age into four categories:
- Children with cough and cold who did not have signs of pneumonia were classified as “no pneumonia”, and their caregivers were advised on appropriate home care.
- Children with fast breathing were classified as “pneumonia” and were given an oral antibiotic (cotrimoxazole/ amoxicillin-at least 40 mg/kg/dose twice daily or 80mg/kg/day) to take at home for five days.
- Children who had chest indrawing with or without fast breathing were classified as “severe pneumonia” and were referred to the closest health facility for treatment with injectable penicillin.
- Children who had any general danger signs (Not able to drink, persistent vomiting, convulsions, lethargic or unconscious, stridor in a calm child or severe malnutrition) were classified as “severe pneumonia or very severe disease”. These children received the first dose of oral antibiotics and were then urgently referred to a health facility for further evaluation and treatment with parenteral antibiotics.
Supportive and symptomatic management is key and includes supplemental oxygen for hypoxia, antipyretics for fever, and fluids for dehydration. This is especially important for non-infectious pneumonitis and viral pneumonia for which antibiotics are not indicated. Cough suppressants are not recommended.
Description of the Intervention[edit | edit source]
Chest physiotherapy is the vital adjuvant treatment of most respiratory illnesses, and is used for children with chronic respiratory or neuromuscular disease
Aim of Chest Physiotherapy[edit | edit source]
add text here relating to the indication for the intervention
Clinical Presentation[edit | edit source]
add text here relating to the clinical presentation of the condition, including pre- and post- intervention assessment measures.
Resources[edit | edit source]
add appropriate resources here, including text links or content demonstrating the intervention or technique
References[edit | edit source]
- ↑ Chaves GS, Freitas DA, Santino TA, Nogueira PA, Fregonezi GA, Mendonça KM. Chest physiotherapy for pneumonia in children. Cochrane Database of Systematic Reviews. 2019(1).
- ↑ Ebeledike C, Ahmad T. Pediatric Pneumonia. InStatPearls [Internet] 2020 Jan 6. StatPearls Publishing.
- ↑ Stuckey-Schrock K, Hayes BL, George CM. Community-acquired pneumonia in children. American family physician. 2012 Oct 1;86(7):661-7.
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