BTS 5-12 years old.

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Presentation transcript:

BTS 5-12 years old

BTS <5years old

Which Inhaler & What Strength? Inhaled corticosteroid (ICS) Bronchodilator Inhaled corticosteroid (ICS) ICS/LABA LABA Seretide 50, 125 & 250 Plus 25mcg Salmeterol Salbutamol 100mcg Beclometasone 50mcg Beclometasone 100mcg Fluticasone 50, 125 & 250mcg Salmeterol 25mcg Meter Dose inhaler Always with Spacer Salbutamol 200mcg Fluticasone 50, 100 & 500mcg Seretide 100, 250 & 500 Plus 50mcg Salmeterol Salmeterol 50mcg Accuhaler Symbicort 100/6, 200/6 & 400/12mcg Formoterol 6 & 12mcg Bricanyl 500mcg Pulmicort 100, 200 & 400mcg Turbohaler Nb: Fluticasone is twice the potency of beclamethasone Image courtesy of UCH

Referral criteria Referral to secondary care if: Diagnosis unclear or in doubt Symptoms present from birth or perinatal lung problem Excessive vomiting or posseting Persistent wet or productive cough Family history of unusual chest disease Failure to thrive Nasal polyps Unexpected clinical findings eg focal signs, abnormal voice or cry, dysphagia, inspiratory stridor Failure to respond to conventional treatment (particularly inhaled corticosteroids above beclometasone 400 mcg/day (or equivalent) or frequent use of steroid tablets) Parental anxiety or need for reassurance