Whooping cough is an acute infectious disease. Whooping cough is an acute infectious disease. The role of the nurse in whooping cough in children
Lecture No. 13
Topic: “Nursing care for tonsillitis, scarlet fever, whooping cough”
Sore throat (acute tonsillitis) -
This is an acute infectious disease primarily affecting the palatine tonsils.
Etiology : staphylococcus, B-hemolytic streptococcus of group A, but there may also be other pathogens (viruses, fungi).
Transmission routes:
1. Airborne
2. Nutritional.
3. Contact and household.
Source of infection :
1. Exogenous (i.e. from patients and bacteria carriers).
2. Endogenous (autoinfection - i.e. infection occurs from the oral cavity of the patient himself in the presence of chronic inflammation of the tonsils or carious teeth).
Predisposing factors : local or general hypothermia.
Clinic:
1. General intoxication syndrome : (fever up to 39-40, headache, chills, general malaise).
2. Sore throat when swallowing .
3. Local changes on the tonsils depend on the form of sore throat.
There are:
1. Catarrhal
2. Follicular
2. Lacunar
Catarrhal tonsillitis. The syndrome of intoxication is not expressed, the temperature is subfebrile. When examining the pharynx, swelling and hyperemia of the palatine tonsils and arches are noted. Regional lymph nodes are enlarged and painful on palpation. Catarrhal tonsillitis can be the initial stage of another form of tonsillitis, and sometimes a manifestation of a particular infectious disease.
Angina follicular and lacunar. Characterized by more severe intoxication (headache, sore throat, temperature up to 39°, chills).
Inspection of the pharynx with follicular angina: suppurating follicles in the form of white or yellowish peas are visible, visible through the mucous membrane. Sometimes the gaps contain yellow or grayish, dense plugs that have an unpleasant putrefactive odor.
Examination of the pharynx with lacunar angina: liquid yellowish-white purulent plaques form in the lacunae, which can merge, covering the entire surface of the tonsils. These deposits can be easily removed with a spatula. In both cases, the tonsils are hyperemic and swollen.
Complications of tonsillitis:
1. Local
Quinsy,
Peritonsillar abscess,
Swelling of the larynx (laryngitis),
Cervical lymphadenitis,
Otitis etc.
2. Infectious-allergic:
Rheumatism, glomerulonephritis
Treatment
- bed rest until temperature normalizes
Drink plenty of warm drinks
Antibiotics (cefuroxime, azithromycin, josamycin) - 5 days
Antihistamines
Rinsing the throat with saline solution, herbal decoctions (chamomile, calendula, eucalyptus)
Irrigation of the pharynx with the preparations ingalipt, bioparox, jox, hexoral and others.
Site observation:
If the child is not hospitalized, then on the first day, before antibiotics are prescribed at home, a swab is taken from the throat and nose for diphtheria (for BL). In the first three days, the patient is actively observed at home by a doctor and nurse. Home regime 10 days.
After recovery:
The patient is given intramuscular bicillin-3 once to prevent rheumatism and nephritis,
General blood and urine tests are done. After a month, the patient should be examined by a doctor again (so as not to miss complications). If necessary, repeat blood and urine tests.
Scarlet fever
This is one of the forms of streptococcal infection, accompanied by fever, sore throat, pinpoint rash, and prone to complications.
Etiology: Caused by group A beta-hemolytic streptococcus.
sources of infection:
1-patient with scarlet fever up to 7-8 days from the onset of the disease;
2 - patients with tonsillitis.
Transmission path:
Airborne and household contact, very rarely food.
Incubation period 2-7 days.
By the end of 1 day, 3 main signs of the disease are formed:
1. Intoxication syndrome
2. inflammation at the entrance gate (angina)
3. pinpoint rash on the skin.
Intoxication manifested by an increase in temperature to high numbers of 38.5-39, poor health, headache, often vomiting.
Angina- complaints of sore throat. When examining the pharynx, there is bright hyperemia and swelling of the tonsils, arches, and soft palate. Sore throat can be catarrhal, lacunar, follicular and even necrotic.
Regional lymph nodes are enlarged.
The tongue has a characteristic appearance during scarlet fever - in the first 2-3 days it is coated in the center with a white coating and is rather dry. The tip of the tongue is crimson in color, from 2-3 days the tongue begins to clear, becomes crimson, with pronounced papillae. " Raspberry" tongue – lasts 1-2 weeks.
By the end of the first, beginning of the second day, it appears simultaneously throughout the body. pinpoint, thick rash on a hyperemic skin background. The skin feels hot, dry, rough (shagreen skin). The favorite place for localization of the rash is in the groin folds, elbow bends, lower abdomen, armpits, and popliteal fossae. The nasolabial triangle always remains free of rash.
All symptoms reach a maximum by day 3 and then gradually fade away.
When the rash fades, most patients develop large-lamellar peeling skin , especially pronounced on the fingers and toes.
- Infectious- otitis media, sinusitis, laryngitis, bronchitis, pneumonia, paratonsillar abscess.
- Allergic- glomerulonephritis, rheumatism, infectious - allergic myocarditis.
Treatment:
At home, hospitalization is subject to children from closed institutions, severe
and complicated forms, children under 3 years old.
-mode bed for the entire acute period.
-A/ b penicillinear row(amoxicillin, augmentin, flemoxin solutab), macrolides(erythromycin, azithromycin), or cephalosporins 1 generation (cephalexin, cefazolin and others).
Antihistamines (tavegil, fenkarol) - according to indications
Symptomatic (antipyretic, gargling).
-specific No;
- nonspecific - consists of isolating patients for 10 days; if recovery has not occurred by the 10th day, then the period is increased.
Those who have recovered are discharged to kindergarten and school after 21 days (to avoid complications such as myocarditis, glomerulonephritis). Children who have been in contact with a person with scarlet fever are observed at home and in preschools for 7 days (temperature, skin, pharynx).
Anti-epidemic measures rallies in DU(children's institution)
1. quarantine for 7 days, final disinfection is carried out in the group, contacts are examined daily (skin, pharynx, thermometry).
Whooping cough
Etiology:
whooping cough is a gram-negative bacillus Bordetellapertussis). There are 4 known serotypes that produce exo- and endotoxins during growth and development. The central nervous system (respiratory and vasomotor centers) is most sensitive to toxins. In the external environment, the rod is unstable and quickly dies because sensitive to high temperature, sunlight, drying, and disinfectants.
Source of infection – patients with typical and atypical forms of whooping cough.
Transmission path – airborne, infection occurs through close and sufficiently long contact (dispersion radius of the pathogen is 2-2.5 meters). Whooping cough affects children of all ages, including newborns.
Main clinical manifestations of whooping cough
1. Incubation period from 3 to 14 days.
2. Catarrhal period 1-2 weeks-
the patient's condition is satisfactory, the temperature is normal or
subfebrile. The cough is dry, obsessive, gradually increasing, and there may be a runny nose.
3. Period of spasmodic cough from 2-3 weeks to 2 months.
A coughing attack consists of coughing impulses following each other on exhalation, interrupted by a whistling, convulsive inhalation - reprise. The attack ends with the discharge of thick, viscous glassy sputum or vomiting. In a typical coughing attack, the patient’s appearance is characteristic: the face turns red, then turns blue, becomes purple-red, the veins of the neck, face, and head swell, and lacrimation is noted. The tongue protrudes from the mouth to the limit. As a result of friction of the frenulum of the tongue on the teeth, a tear or ulcer forms. Outside of an attack, puffiness of the face, swelling of the eyelids, and pale skin persist. Hemorrhages in the sclera and petechial rash on the face and neck are possible.
4. Permission period from 2 to 3 weeks -
The cough loses its typical character and occurs less and less frequently, but attacks can be provoked by emotional stress or physical exertion. For 2-6 months, the child’s increased excitability remains, trace reactions are possible (return of paroxysmal, convulsive cough when ARVI is added).
Features of modern whooping cough– the predominance of mild and atypical forms due to mass pertussis immunization.
Features of whooping cough in young children:
Periods 1 and 2 were shortened, period 3 was extended to 50-60 days;
Coughing attacks may not occur repeatedly, but are often accompanied by cessation of breathing, and there may be convulsions;
More often complications occur: (diarrhea syndrome, encephalopathy, pulmonary emphysema, pertussis pneumonia, atelectasis, cerebrovascular accident, bleeding and hemorrhages in the brain, retina, umbilical or inguinal hernia, rectal prolapse and others).
Laboratory diagnostics:
1) “cough patch” method
2) a smear from the back of the throat - a tank inoculated on Bordet-Giangou medium (potato-glycerin agar with the addition of blood and penicillin) or KUA (casein-charcoal agar).
3) RPGA - for diagnosing whooping cough in the later stages or when examining the focus. Diagnostic titer 1:80.
4) molecular method - PCR (polymer chain reaction).
5) OAK – leukocytosis with lymphocytosis (or isolated lymphocytosis) with normal ESR.
Treatment:
Subject to hospitalization children with severe forms, with complications, with an unsmooth course, unfavorable premorbid background, with exacerbation of chronic diseases and young children. According to epidemic indications - children from closed institutions.
Mode- gentle, with mandatory individual walks.
Diet– in severe forms, feed more often and in small portions,
after vomiting, supplement feeding.
Etiotropic therapy: antibiotics-– erythromycin, roxithromycin (rulid), azithromycin (sumamed) for 5-7-10 days, effective in the early stages of the disease.
Pathogenetic therapy:
P/convulsive (phenobarbital, chlorpromazine);
Calming (valerian);
Dehydration therapy (diacarb or furosemide);
Mucolytics and antitussives (tussin plus, broncholitin, libexin, tusuprex, sinekod);
Antihistamines (claritin, suprastin);
Vitamins with microelements;
For severe forms - prednisolone;
Oxygen therapy, for apnea - mechanical ventilation;
Eufillin (for bronchoabstruction and cerebrovascular accidents);
Physiotherapy, chest massage, exercise therapy;
P/pertussis immunoglobulin (children under 2 years old).
Prevention
-specific- DTP (tetracoccus) from 3 months 3 times, with an interval of 45 days, revaccination at 18 months.
-nonspecific
Isolate the patient for 14 days. Children who have been in contact with the patient are observed for 7 days, a double bacteriological examination is carried out for children from the family when treating a patient with whooping cough at home. Contact children of the first year of life and unvaccinated children under 2 years of age are given antitoxic anti-pertussis immunoglobulin.
What is this disease?
Whooping cough is an extremely contagious respiratory tract infection. The disease is characterized by sudden attacks of spasmodic coughing, which usually end with a wheezing inhalation. The peak incidence occurs in early spring and late winter. Half of the cases are unvaccinated children under two years of age.
As a result of mass immunization and timely recognition of the disease, the number of deaths from whooping cough has sharply decreased. Children under one year old die from pneumonia and other complications; Whooping cough is also dangerous for very elderly people, but in children over one year old and in adults it is usually less severe.
What are the causes of the disease?
The causative agent of whooping cough is coccobacteria. The infection is usually transmitted by airborne droplets from a patient in the acute phase of the disease; much less often through bedding and other objects contaminated with secretions from the nasopharynx.
What are the symptoms of the disease?
7-10 days after infection, coccobacilli enter the respiratory tract, where they cause the formation of viscous mucus. Classic whooping cough lasts 6 weeks; during its course there are 3 periods; each duration is 2 weeks.
The catarrhal period is characterized by an irritating cough, night cough, loss of appetite, sneezing, restlessness and sometimes a slight increase in temperature. During this period, whooping cough is especially contagious.
The spasmodic period begins 7-14 days from the onset of the disease. It is characterized by paroxysmal convulsive cough with the release of viscous mucus. Each coughing attack usually ends with a noisy, convulsive breath, and choking on mucus can lead to vomiting. (Very young children may not have this typical gasping breath.)
In the intervals between breaths during a convulsive cough, complications such as increased pressure in the veins, nosebleeds, swelling around the eyes, hemorrhages under the conjunctiva, retinal detachment (and blindness), rectal prolapse, hernia, seizures and pneumonia are possible. In children, convulsive cough can cause periodic respiratory arrest, oxygen deficiency and metabolic disorders.
During this period, patients are very vulnerable to secondary bacterial or viral infections, which can be fatal. When a temperature appears, a secondary infection can be assumed.
Recovery period. At this time, coughing attacks and vomiting gradually subside. However, within a few months, even after a mild respiratory tract infection, the convulsive cough may begin again.
How is whooping cough diagnosed?
Classic symptoms - especially during the convulsive period of the disease - allow one to suspect whooping cough and order laboratory tests to confirm the diagnosis. Isolation of the bacilli carrier using a throat swab is possible only in the early stages of the disease. Typically, at the beginning of the convulsive period, leukocytosis increases, especially in children older than 6 months.
How is the disease treated?
Patients with severe attacks of convulsive cough should be hospitalized; They will receive fluids and electrolytes in the hospital. Treatment consists of proper nutrition, codeine and mild sedatives are prescribed to reduce cough; if the patient experiences periodic respiratory arrests, oxygen therapy is necessary; Antibiotics are used to prevent the development of secondary infections.
A patient with a spasmodic cough must be isolated. When caring for someone who has whooping cough, you should wear a mask. Care should be taken to create a calm environment so as not to provoke coughing attacks. It is better to feed patients in small portions, but more often.
Whooping cough vaccinations
Since infants are especially susceptible to whooping cough, immunization (diphtheria-tetanus-pertussis vaccine) is usually given at 2, 4 and 6 months. At 18 months and at 4-6 years, additional vaccinations are given.
The vaccine may harm the nervous system and cause other complications, but the risk of getting whooping cough is higher than the risk of developing complications.
Forecast.
The prognosis of whooping cough largely depends on the age of the child, the severity of the course and the presence of complications. For older children, whooping cough is not very dangerous.
The prognosis remains serious in young children when complications occur (pneumonia, asphyxia, encephalopathy).
Mortality among children under one year of age reaches 0.1-0.9%.
Basic principles of treatment.
Young children with severe whooping cough, complications or concomitant diseases are subject to hospitalization.
It is necessary to create a protective regime, to eliminate as much as possible all irritants (mental, physical, pain, etc.).
The main task of pathogenetic therapy in severe forms is to combat hypoxia; oxygen therapy is carried out in oxygen tents, while the oxygen concentration should not be higher than 40%; in mild and moderate forms, aerotherapy (long stay in the fresh air) is indicated; in case of respiratory arrest, mechanical ventilation is indicated.
To improve bronchial patency, aminophylline is prescribed orally or parenterally (especially in case of signs of cerebrovascular accident, obstructive syndrome, pulmonary edema).
To liquefy viscous sputum: mucaltin, mucopront, potassium iodide solution; antitussive drugs for children over 2 years of age - glaucine hydrochloride, glauvent, etc.
Inhalation with a solution of sodium bicarbonate, aminophylline, novocaine, ascorbic acid.
Carrying out postural drainages, suctioning mucus.
Diet food.
Sedatives: seduxen, phenobarbital (reduce the frequency of attacks).
Immunomodulators.
Antibacterial therapy: erythromycin, Rulid, vilprafen, summed (prevent the colonization of pertussis bacteria, but their effectiveness is limited to the early stages of illness; in addition, they are indicated when a secondary bacterial infection is attached) the course of treatment is 8-10 days.
Anti-pertussis immunoglobulin (children under 2 years old).
Vitamin therapy.
Preventive and anti-epidemic measures for whooping cough:
In conditions of incomplete and late diagnosis, the patient is isolated for 30 days from the onset of the disease at home, and in severe forms and for epidemic indications, hospitalization is carried out.
The outbreak is quarantined for 14 days from the moment of separation from the sick person, contacts are identified, registered and monitored daily (identifying those who are coughing) with 2-fold bacteriological examination, with an interval of 7-17 days (until receiving 2- x negative tests).
Only children 7 years old are subject to separation.
Carrying out routine disinfection during quarantine.
Specific prevention: routine active immunization of children under one year of age with DTP (associated pertussis-diphtheria-tetanus vaccine).
DTP vaccination: from 3 months three times with an interval of 30 days.
I revaccination with DPT - 1.5-2 years after vaccination.
Vaccinations against whooping cough are not given to children over 3 years of age.
Children under one year of age who have not been vaccinated against whooping cough are given immunoglobulin according to indications.
Nursing process for whooping cough.
Timely identify real and potential problems, violated needs of the patient and his family members.
Possible patient problems:
disturbance of physiological functions (loose stools);
impairment of motor activity;
change in appearance;
the child’s inability to independently cope with difficulties arising as a result of the disease;
psycho-emotional stress;
complication of the disease.
sleep disturbance;
loss of appetite;
persistent, obsessive cough;
breathing problems;
Possible problems for parents:
family maladaptation due to the child’s illness;
fear for the child;
uncertainty about the successful outcome of the disease;
lack of knowledge about the disease and care;
inadequate assessment of the child’s condition;
chronic fatigue syndrome.
Nursing intervention.
Inform parents about the causes of development, features of the course of whooping cough, principles of treatment and care, preventive measures, and prognosis.
Limit as much as possible the interaction of a sick child with other children.
Ensure that the patient is isolated at home until 2 negative bacteriological examination results are obtained, and in severe forms, assist in arranging hospitalization.
Ensure sufficient aeration of the room where the sick child is located. It is optimal if the windows are constantly open; the child needs this, especially at night, when the most severe coughing attacks occur (in the fresh air they settle down, are less pronounced and complications arise much less frequently).
Teach parents to provide first aid in case of vomiting and convulsions. Follow all doctor's orders in a timely manner.
Create a calm, comfortable environment around the child, protect him from unnecessary worries and painful manipulations. Involve parents in the process of caring for the child, teach them how to properly sanitize the respiratory tract, carry out inhalations with a 2% sodium bicarbonate solution, and vibration massage.
Provide the child with nutrition adequate to his condition and age; it should be complete, enriched with vitamins (especially vitamin C, which promotes better absorption of oxygen). Easily digestible liquid and semi-liquid foods are recommended: dairy cereals or vegetable pureed vegetarian soups, rice, semolina porridge, mashed potatoes, low-fat cottage cheese; the consumption of bread, animal fats, cabbage, extractive and spicy foods should be limited. In severe forms of the disease, give liquid and semi-liquid food (not containing crumbs, lumps), often and in small portions. If vomiting occurs frequently, it is necessary to supplement the child's feeding after an attack and vomiting.
The amount of liquid consumed should be increased to 1.5-2 liters, introduce rosehip decoction, tea with lemon, fruit drinks, warm degassed mineral alkaline waters (Borjomi, Narzan, Smirnovskaya) or a 2% solution of soda in half with warm milk.
Advise parents to organize interesting leisure time for the child: diversify it with new toys, books, decals and other calm age-appropriate games (since attacks of whooping cough intensify with excitement and increased physical activity).
Protect the patient from communicating with patients with ARVI, since the addition of secondary viral-bacterial infections creates a threat of developing pneumonia and increasing the severity of whooping cough.
Organize routine disinfection at home (disinfect dishes, toys, care items, furnishings, carry out wet cleaning with soap and soda solution 2 times a day).
During the period of convalescence, it is recommended that the child undergo nonspecific disease prevention (nutritious nutrition enriched with vitamins, sleep in the fresh air, hardening, dosed physical activity, exercise therapy, physiotherapy, massage).
Create an expert nursing process map
for whooping cough
Questions for self-study:
Define whooping cough.
What properties does the whooping cough pathogen have?
What are the sources of infection?
What are the mechanisms and routes of transmission of infection?
What is the mechanism of whooping cough development?
What are the main clinical manifestations of whooping cough during the catarrhal period?
What are the main clinical manifestations of whooping cough during the spasmodic period?
What are the characteristics of whooping cough in children under one year of age?
What are the basic principles of treating whooping cough?
What preventive and anti-epidemic measures are taken for whooping cough?
What complications can develop with whooping cough?
MAP OF THE NURSING PROCESS
(result of disease dynamics)
|
date |
Stage 1 Collection of information |
Stage 2 Patient problems |
Stage 3 Care plan |
Stage 4 Implementation of the care plan |
Stage 5 Assessing the effectiveness of care |
|
Used but not reflected in daily monitoring The examination can be subjective (questioning) Objective (examination, anthropometry, percussion, auscultation, etc.) Study of medical documentation (history of development, survey data) |
Real Primary (priority) and secondary Priority Potential |
Short term goals (less than a week) Long-term goals (more than a week) Independent interventions (does not require doctor's orders) Dependent interventions (based on doctor's orders or instructions) Interdependent interventions (carried out jointly with another health worker) |
Effect achieved: fully not completely partially not achieved |
Whooping cough – acute infectious disease with a cyclic course and characteristic bouts of convulsive cough. Etiology. Pathogen infections - bacteria in the form of short rods - was discovered by the Belgian scientist Bordet and the French scientist Zhang in 1906. Infection occurs by airborne droplets More often, whooping cough affects children from 1 to 5 years old, but sometimes children under the age of one year are affected. The incubation period lasts from 2 to 15, but more often it is 5–9 days. At this time, symptoms of the disease do not appear. Then, during the course of the disease, three periods are distinguished: catarrhal, convulsive and resolution. Catarrhal period lasts up to 2 weeks. The onset of the disease is atypical. General malaise develops, a runny nose appears, a cough gets worse every day, the temperature rises to low-grade (37–38 °C), and then drops to normal. Convulsive period lasts from 1 to 5 weeks. The number of convulsive coughing attacks increases from 10 to 50 per day. Disease resolution period lasts 1–3 weeks. Gradually the cough becomes weaker, convulsive attacks are less frequent and less prolonged, and recovery begins. Total duration Whooping cough can be from 5 to 12 weeks. The patient is considered contagious for 30 days from the onset of illness. Complications: pneumonia, bronchitis (especially in children from 1 to 3 years), respiratory arrest, nosebleeds. Caring for sick children. Properly organized patient care plays an important role in treatment. It should be located in a separate room, in which wet cleaning and thorough ventilation are carried out 2 times a day. Bed rest is prescribed only in case of elevated temperature and complications. A sick child with a normal temperature should spend more time in the fresh air, but separately from healthy children. Fresh cold air has a very good effect on children with whooping cough, improving ventilation of the lungs and increasing the supply of oxygen to the body: coughing attacks become less frequent and weaker. Feeding children should be frequent (up to 10 times a day), but in small portions and better after a coughing attack. Regardless of the severity of the disease, the main place in treatment is given to antibiotics as prescribed by the doctor. Prevention Whooping cough in a group of children requires isolation of the patient, which is usually organized at home. Isolation continues until the 30th day from the onset of the disease. Children under 7 years of age who have not had whooping cough and have not received vaccinations are separated from children's groups for 14 days after contact with a sick person. Children over 7 years of age, as well as adults working in child care institutions and in contact with the patient, are subject to medical supervision for 14 days.
At all times, when treating patients with whooping cough, doctors paid great attention to general hygiene rules - regimen, care and nutrition.
In the treatment of whooping cough, antihistamines (diphenhydramine, suprastin, tavegil), vitamins, inhalation aerosols of proteolytic enzymes (chymopsin, chymotrypsin), which facilitate the discharge of viscous sputum, and mucaltin are used.
Mostly children in the first half of the year with severe illness are subject to hospitalization due to the risk of developing apnea and serious complications. Hospitalization of older children is carried out in accordance with the severity of the disease and for epidemiological reasons. In the presence of complications, indications for hospitalization are determined by their severity, regardless of age. It is necessary to protect patients from infection.
It is recommended that seriously ill infants be placed in a darkened, quiet room and disturbed as little as possible, since exposure to external stimuli can cause severe paroxysm with anoxia. For older children with mild forms of the disease, bed rest is not required.
Severe manifestations of pertussis infection (profound respiratory rhythm disturbances and encephalic syndrome) require resuscitation measures as they can be life-threatening.
Erased forms of whooping cough do not require treatment. It is enough to eliminate external irritants to ensure peace and longer sleep for those with whooping cough. In mild forms, you can limit yourself to long stays in the fresh air and a small number of symptomatic measures at home. Walks should be daily and long. The room in which the patient is located must be systematically ventilated and its temperature should not exceed 20 degrees. During a coughing attack, you need to take the child in your arms, slightly lowering his head.
If mucus accumulates in the oral cavity, you need to empty the child's mouth using a finger wrapped in clean gauze...
Diet. Careful attention should be paid to nutrition, as pre-existing or developing nutritional deficiencies can significantly increase the likelihood of an adverse outcome. It is recommended to give food in fractional portions.
The prescription of antibiotics is indicated in young children, with severe and complicated forms of whooping cough, in the presence of concomitant diseases in therapeutic doses for 7-10 days. Ampicillin, gentamicin, and erythromycin have the best effect. Antibacterial therapy is effective only in the early stages of uncomplicated whooping cough, in catarrhal whooping cough and no later than the 2-3rd day of the convulsive period of the disease.
The prescription of antibiotics during the spasmodic period of whooping cough is indicated when whooping cough is combined with acute respiratory viral diseases, with bronchitis, bronchiolitis, and in the presence of chronic pneumonia. One of the main tasks is the fight against respiratory failure.
The most important treatment for severe whooping cough in children of the first year of life. Oxygen therapy is necessary using systematic oxygen supply, cleaning the airways from mucus and saliva. When breathing stops - suction of mucus from the respiratory tract, artificial ventilation of the lungs. For signs of brain disorders (tremors, short-term convulsions, increasing anxiety), seduxen is prescribed and, for dehydration purposes, lasix or magnesium sulfate. From 10 to 40 ml of a 20% glucose solution with 1-4 ml of a 10% calcium gluconate solution is administered intravenously, to reduce pressure in the pulmonary circulation and to improve bronchial patency - aminophylline, for children with neurotic disorders - bromine preparations, luminal, valerian. With frequent severe vomiting, parenteral fluid administration is necessary.
Antitussives and sedatives. The effectiveness of expectorants, cough suppressants and mild sedatives is questionable; they should be used with caution or not at all. Exposures that provoke cough should be avoided (mustard plasters, cups)
For the treatment of patients with severe forms of the disease - glucocorticosteroids and/or theophylline, salbutamol. During attacks of apnea, chest massage, artificial respiration, oxygen.
Prevention upon contact with a sick person
In unvaccinated children, normal human immunoglobulin is used. The drug is administered twice with an interval of 24 hours as early as possible after contact.
Chemoprophylaxis with erythromycin can also be carried out at an age-specific dosage for 2 weeks.
whooping cough vaccine
