Breathing difficulties and asthma

A Foundation Doctor working in a Paediatric or Accident and Emergency department will definitely encounter children with breathing difficulties, and most of these children will have upper or lower respiratory tract illnesses, few of which may present as potentially life-threatening emergencies. It is important to remember that young children and infants may develop respiratory failure more readily than older children and adults. Some of the common respiratory conditions presenting with breathing difficulty in infants and children are bronchiolitis, croup and acute asthma. The diagnosis of all of these is clinical. This article discusses how to use the A-B-C-D-E approach when faced with a child with breathing difficulty while waiting for senior help. The clinical features of croup, bronchiolitis and acute asthma and their management are discussed, highlighting important ‘dos and don’ts’.