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"
Angina (acute tonsillitis) -
This is an acute infectious disease with a predominant lesion of the palatine tonsils.
Etiology : staphylococcus, B-hemolytic streptococcus of group A, but there may be other pathogens (viruses, fungi).
Transmission routes:
1. Airborne
2. Alimentary.
3. Contact household.
Source of infection :
1. Exogenous (i.e. from patients and bacteria carriers).
2. Endogenous (autoinfection - that is, infection occurs from the oral cavity of the patient himself in the presence of chronic inflammation of the palatine tonsils or carious teeth).
Predisposing factors : local or general hypothermia.
Clinic:
1. Syndrome of general intoxication : (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 angina.
Distinguish:
1. Catarrhal
2. Follicular
2. Lacunar
Angina catarrhal. 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 angina can be the initial stage for another form of angina, and sometimes a manifestation of a particular infectious disease.
Angina follicular and lacunar. They are characterized by more pronounced intoxication (headache, sore throat, temperature up to 39 °, chills).
Inspection of the pharynx with follicular angina: festering follicles are visible in the form of white or yellowish peas, translucent through the mucous membrane. Sometimes there are yellow or grayish, dense plugs in the lacunae, which have an unpleasant putrefactive odor.
Examination of the pharynx with lacunar angina: liquid yellowish-white purulent deposits are formed in the lacunae, which can merge, covering the entire surface of the tonsils. These raids are easily removed with a spatula. In both cases, the tonsils are hyperemic, edematous.
Complications of angina:
1. Local
Quinsy,
paratonsillar abscess,
Swelling of the larynx (laryngitis),
cervical lymphadenitis,
Otitis, etc.
2. Infectious-allergic:
Rheumatism, glomerulonephritis
Treatment
- bed rest until temperature returns to normal
Plentiful warm drink
Antibiotics (cefuroxime, azithromycin, josamycin) - 5 days
Antihistamines
Rinsing the throat with saline, decoctions of herbs (chamomile, calendula, eucalyptus)
Irrigation of the pharynx with preparations of ingalipt, bioparox, joks, hexoral and others.
Site supervision:
If the child is not hospitalized, then on the first day, before prescribing antibiotics at home, a swab is taken from the throat and nose for diphtheria (on BL). In the first three days, the patient is actively monitored at home by a doctor and nurse. Home mode 10 days.
After recovery:
The patient is administered intramuscularly bicillin-3 once for the prevention of rheumatism and nephritis,
General blood and urine tests are done. A month later, 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, tonsillitis, punctate rash, 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 angina.
Transmission way:
Airborne and contact-household, very rarely food.
Incubation period 2-7 days.
By the end of the 1st day, 3 main signs of the disease are formed:
1. Syndrome intoxication
2. inflammation at the entrance gate (angina)
3. small rash on the skin.
Intoxication manifested by an increase in temperature to high numbers of 38.5-39, a violation of well-being, headache, often vomiting.
Angina- complaints of sore throat. When examining the pharynx, there is a bright hyperemia and swelling of the tonsils, arches, and soft palate. Angina can be catarrhal, lacunar, follicular and even necrotic.
Regional l/nodes increase.
A characteristic appearance in scarlet fever is the tongue - in the first 2-3 days it is lined in the center with a white coating, dryish. The tip of the tongue is crimson, from 2-3 days the tongue begins to clear, becomes crimson, with pronounced papillae. " Crimson" language - Lasts 1-2 weeks.
By the end of the first, the beginning of the second day, at the same time, all over the body appears small, thick rash on hyperemic background of the skin. The skin feels hot, dry, rough (shagreen skin). A favorite place for localization of the rash is in the inguinal folds, elbows, lower abdomen, in the armpits, in the popliteal fossae. The nasolabial triangle always remains free from the rash.
All symptoms reach a maximum by day 3, and then gradually fade away.
When the rash subsides, most patients develop large-lamellar peeling of the 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.
-BUT/ b penicilline 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 in isolating patients for 10 days, if recovery has not occurred by day 10, then the period increases.
Those who have recovered are discharged to kindergartens and schools after 21 days (to avoid complications such as myocarditis, glomerulonephritis). Children who have been in contact with a patient with scarlet fever at home and in kindergartens are observed for 7 days (temperature, skin, pharynx).
Anti-epidemic measures riiya in remote control(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). 4 serotypes are known, which in the process of growth and development form exo- and endotoxins. The CNS (respiratory and vasomotor centers) is most sensitive to toxins. In the external environment, the rod is unstable and quickly dies because. sensitive to heat, sunlight, drying, exposure to disinfectants.
Source of infection - Patients with typical and atypical forms of whooping cough.
Transmission route - airborne, infection occurs with close and sufficiently long contact (the radius of dispersion of the pathogen is 2-2.5 meters). Whooping cough affects children of all ages, including newborns.
The 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, there may be a runny nose.
3. Period of spasmodic cough from 2-3 weeks to 2 months.
A coughing fit is a coughing shock following one after another on exhalation, interrupted by a whistling, convulsive breath - reprise. The attack ends with the discharge of thick, viscous vitreous sputum or vomiting. With a typical attack of coughing, the appearance of the patient is characteristic: the face turns red, then turns blue, becomes purple-red, the veins of the neck, face, head swell, lacrimation is noted. The tongue protrudes from the mouth to the limit. As a result of friction of the frenulum of the tongue against the teeth, an anguish or sore formation occurs. Outside the attack, puffiness of the face, swelling of the eyelids, and pallor of the skin persist. Hemorrhages in the sclera and petechial rash on the face and neck are possible.
4. Permission period from 2 to 3 weeks -
cough loses its typical character, occurs less and less often, but attacks can be provoked by emotional stress or physical exertion. Within 2-6 months, the increased excitability of the child remains, trace reactions are possible (return of a paroxysmal, convulsive cough with the addition of SARS).
Features of modern whooping cough- the predominance of mild and atypical forms due to mass pertussis immunization.
Features of whooping cough in young children:
Shortened periods 1 and 2, 3 - extended to 50-60 days;
Coughing fits can be without reprises, but are often accompanied by respiratory arrest, there may be convulsions;
Complications occur more often: (diarrheal syndrome, encephalopathy, emphysema, pertussis pneumonia, atelectasis, cerebrovascular accident, bleeding and hemorrhages in the brain, retina, umbilical or inguinal hernia, rectal prolapse, and others).
Laboratory diagnostics:
1) the "cough plate" method
2) a smear from the posterior pharyngeal wall - a tank of sowing on Borde-Gangu medium (potato-glycerol agar with the addition of blood and penicillin) or AMC (casein-coal agar).
3) RPHA - for the diagnosis of 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:
Hospitalizations are subject children with severe forms, with complications, with a non-smooth course, an unfavorable premorbid background, with an exacerbation of chronic diseases and young children. According to epidemic indications - children from closed institutions.
Mode- sparing, with obligatory individual walks.
Diet- in severe forms, feed more often and in small portions,
supplement after vomiting.
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, broncholithin, libexin, tusuprex, sinekod);
Antihistamines (claritin, suprastin);
Vitamins with trace elements;
In severe forms - prednisolone;
Oxygen therapy, with apnea - mechanical ventilation;
Eufillin (with 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.
-non-specific
Isolation of 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 hearth when treating a patient with whooping cough at home. Contact children of the first year of life and unvaccinated children up to 2 years of age should be given antitoxic antipertussis 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 in wheezing. The peak incidence occurs in early spring and late winter. Half of the cases are unvaccinated children under the age of two.
As a result of mass immunization and timely recognition of the disease, the number of deaths from whooping cough has decreased dramatically. Children under one year old die from pneumonia and other complications; whooping cough is also dangerous for the very elderly, but it tends to be less severe in older children and adults.
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 items 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; in its course, 3 periods are distinguished; the duration of each is 2 weeks.
The catarrhal period is characterized by an irritating cough, nocturnal cough, loss of appetite, sneezing, restlessness, and sometimes a slight fever. During this period, whooping cough is especially contagious.
The spasmodic period begins 7-14 days after the onset of the disease. It is characterized by paroxysmal convulsive cough with the release of viscous mucus. Each bout of coughing usually ends in a noisy, convulsive breath, and choking on mucus can lead to vomiting. (Very young children may not have this typical gasping breath.)
In 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, convulsions and pneumonia are possible. In children, convulsive coughing can cause intermittent respiratory arrest, oxygen deficiency, and metabolic disorders.
During this period, patients are very vulnerable to the addition of secondary bacterial or viral infections, which can be deadly. With the appearance of temperature, a secondary infection can be assumed.
Recovery period. At this time, coughing fits and vomiting gradually subside. However, even after a mild respiratory tract infection, a whooping cough may return within a few months.
How is whooping cough diagnosed?
Classical symptoms - especially in the convulsive period of the disease - make it possible to suspect whooping cough and prescribe laboratory tests to confirm the diagnosis. Isolation of a bacillus carrier using a throat swab is possible only in the early stages of the disease. Usually 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; in the hospital they will receive fluids and electrolytes. Treatment consists of proper nutrition, codeine and mild sedatives are prescribed to reduce cough; if the patient has periodic respiratory arrests, oxygen therapy is necessary; antibiotics are used to prevent secondary infections.
A patient with a spasmodic cough needs to be isolated. Wear a mask when caring for whooping cough. Care should be taken to create a calm environment so as not to provoke coughing fits. It is better to feed patients in small portions, but more often.
Whooping cough vaccines
Since infants are especially susceptible to whooping cough, immunization (pertussis-diphtheria-tetanus vaccine) is usually given at 2, 4 and 6 months. At 18 months and at 4-6 years, additional vaccinations are given.
The vaccine can damage the nervous system and cause other complications, but the risk of getting whooping cough is greater than the risk of complications.
Forecast.
The prognosis of pertussis largely depends on the age of the child, the severity of the course and the presence of complications. Whooping cough is not very dangerous for older children.
The prognosis remains serious in young children with the addition of complications (pneumonia, asphyxia, encephalopathy).
Mortality among children under one year old reaches 0.1-0.9%.
Basic principles of treatment.
Children of early age with a severe form of whooping cough, with complications or with concomitant diseases are subject to hospitalization.
It is necessary to create a protective regime, to exclude as much as possible all irritants (mental, physical, painful, 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 exceed 40%, in mild and moderate forms, aerotherapy is indicated (prolonged exposure to fresh air), when breathing stops - mechanical ventilation.
To improve bronchial patency, eufillin is prescribed orally or parenterally (especially in the event of signs of cerebrovascular accident, with obstructive syndrome, pulmonary edema).
To thin viscous sputum: mukaltin, mucopront, potassium iodide solution; antitussive drugs for children after 2 years - glaucine hydrochloride, glauvent, etc.
Inhalations with a solution of sodium bicarbonate, aminophylline, novocaine, ascorbic acid.
Carrying out postural drainages, suction of mucus.
Diet food.
Sedatives: seduxen, phenobarbital (reduce the frequency of seizures).
Immunomodulators.
Antibacterial therapy: erythromycin, rulid, vilprafen, sumamed (prevent the colonization of pertussis bacteria, but their effectiveness is limited by the early stages of infection, in addition, they are indicated when a secondary bacterial infection is attached) treatment course - 8-10 days.
Pertussis immunoglobulin (children under 2 years).
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 according to epidemic indications, hospitalization is carried out.
The focus is quarantined for 14 days from the moment of separation from the sick person, contacts are identified, they are registered and monitored daily (coughing detection) with a 2-fold bacteriological examination, with an interval of 7-17 days (until 2- x negative tests).
Only children of 7 years old are subject to separation.
Carrying out current disinfection during quarantine.
Specific prophylaxis: 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 of DTP - 1.5-2 years after vaccination.
Vaccinations against whooping cough are not available for children older than 3 years.
Children under one year of age who have not been vaccinated against whooping cough are given immunoglobulin according to indications.
Nursing process in whooping cough.
Timely identify real and potential problems, violated needs of the patient and his family members.
Possible patient problems:
violation of physiological functions (loose stools);
violation of motor activity;
change in appearance;
the inability of the child to independently cope with the difficulties that arose as a result of the disease;
psycho-emotional stress;
complication of the disease.
sleep disturbance;
loss of appetite;
persistent, obsessive cough;
respiratory failure;
Possible problems for parents:
maladaptation of the family due to the illness of the child;
fear for the child;
uncertainty about the successful outcome of the disease;
lack of knowledge about illness and care;
inadequate assessment of the child's condition;
chronic fatigue syndrome.
Nursing intervention.
Inform parents about the causes of development, the course of whooping cough, the principles of treatment and care, preventive measures, and prognosis.
Limit the contact of a sick child with other children as much as possible.
Provide isolation of the patient at home until 2 negative results of bacteriological examination are obtained, and in severe cases, provide assistance in organizing hospitalization.
Ensure adequate aeration of the room where the sick child is located. Optimally, if the windows are constantly open, this is necessary for the child, especially at night, when the most severe coughing attacks occur (in the fresh air they settle down, are less pronounced and complications occur 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 unrest and painful manipulations. Involve parents in the process of caring for a child, teach them how to properly sanitize the airways, conduct inhalations with a 2% solution of sodium bicarbonate, vibration massage.
Provide the child with nutrition adequate to his condition and age, it should be complete, enriched with vitamins (especially vitamin C, which contributes to better absorption of oxygen). Easily digestible liquid and semi-liquid foods are recommended: dairy cereal or vegetable mashed vegetarian soups, rice, semolina porridge, mashed potatoes, fat-free cottage cheese, you should limit the consumption of bread, animal fats, cabbage, extractive and spicy foods. In severe forms of the disease, give liquid and semi-liquid food (not containing crumbs, lumps), often and in small portions. With frequent vomiting, it is necessary to supplement the child after an attack and vomiting.
The amount of liquid consumed should be increased to 1.5-2 liters, a rosehip broth, tea with lemon, fruit drinks, warm degassed alkaline mineral waters (Borjomi, Narzan, Smirnovskaya) or a 2% solution of soda mixed in half with warm milk should be introduced.
Advise parents to organize an interesting leisure time for the child: diversify it with new toys, books, decals and other calm games according to age (since whooping cough attacks increase with excitement and increased physical activity).
Protect the patient from communicating with patients with acute respiratory viral infections, since the addition of secondary viral and bacterial infections creates a threat of developing pneumonia and an increase in the severity of whooping cough.
Organize current disinfection at home (disinfect dishes, toys, care items, furnishings, carry out wet cleaning twice a day with a soap and soda solution).
In the period of convalescence, it is recommended that the child be given non-specific disease prevention (complete nutrition enriched with vitamins, sleeping in the fresh air, hardening, dosed physical activity, exercise therapy, physiotherapy, massage).
Map the Nursing Process
whooping cough
Questions for self-study:
Define whooping cough.
What are the properties of the whooping cough pathogen?
What are the sources of infection?
What is the mechanism and ways of transmission of infection?
What is the development mechanism of whooping cough?
What are the main clinical manifestations of whooping cough in the catarrhal period?
What are the main clinical manifestations of whooping cough in the spasmodic period?
What are the features of the course of whooping cough in children under one year old?
What are the basic principles of whooping cough treatment?
What preventive and anti-epidemic measures are taken for whooping cough?
What complications can develop with whooping cough?
NURSING PROCESS MAP
(the result of the dynamics of the disease)
|
the date |
Stage 1 Collection of information |
Stage 2 Patient problems |
Stage 3 care plan |
Stage 4 Implementation of the care plan |
Stage 5 Evaluation of the effectiveness of care |
|
Used but not reflected in daily monitoring The examination is subjective (questioning) Objective (examination, anthropometry, percussion, auscultation, etc.) Study of medical records (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 (do not require doctor's orders) Dependent interventions (based on doctor's orders or instructions) Mutually dependent interventions (carried out together 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 Zhangu in 1906. Infection occurs by airborne droplets More often, whooping cough affects children from 1 to 5 years, but sometimes children under the age of one are sick. The incubation period lasts from 2 to 15, but more often it is 5–9 days. At this time, the 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. A general malaise develops, a runny nose, a cough that gets worse every day, the temperature rises to subfebrile (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, 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 the illness. Complications: pneumonia, bronchitis (especially in children from 1 to 3 years old), respiratory arrest, nosebleeds. Care of sick children. An important place in the treatment is properly organized patient care. It should be in a separate room, in which wet cleaning and thorough ventilation are carried out 2 times a day. Bed rest is prescribed only at elevated temperature and the occurrence of 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, which improves ventilation of the lungs and increases the flow of oxygen into the body: coughing fits 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 fit. Regardless of the severity of the disease, the main place in the treatment is given to antibiotics prescribed by a doctor. Prevention whooping cough in the children's team provides for 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, after contact with the patient, are separated from children's groups for 14 days. Children over 7 years of age, as well as adults working in childcare facilities 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 are used (diphenhydramine, suprastin, tavegil), vitamins, inhalation aerosols of proteolytic enzymes (chymopsin, chymotrypsin), which facilitate the discharge of viscous sputum, mukaltin.
Mostly children of the first half of the year with a pronounced severity of the disease 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 epidemic 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.
Severely ill infants should be placed in a darkened, quiet room and disturbed as little as possible, since exposure to external stimuli can cause severe paroxysms with anoxia. For older children with mild forms of the disease, bed rest is not required.
Severe manifestations of pertussis infection (profound respiratory rhythm disorders and encephalic syndrome) require resuscitation, as they can be life-threatening.
Erased forms of whooping cough do not require treatment. It is enough to eliminate external stimuli to ensure peace and longer sleep for patients with whooping cough. In mild forms, prolonged exposure to fresh air and a small number of symptomatic measures at home can be limited. Walks should be daily and long. The room in which the patient is located should be systematically ventilated and its temperature should not exceed 20 degrees. During an attack of coughing, you should take the child in your arms, slightly lowering his head.
With the accumulation of mucus in the oral cavity, it is necessary to free the child's mouth with a finger wrapped in clean gauze ...
Diet. Serious attention should be paid to nutrition, since pre-existing or developed nutritional deficiencies can significantly increase the likelihood of an adverse outcome. Food is recommended to give fractional portions.
The appointment 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. The best effect is provided by ampicillin, gentamicin, erythromycin. Antibacterial therapy is effective only in the early stages of uncomplicated whooping cough, in catarrhal and no later than 2-3 days of the convulsive period of the disease.
The appointment of antibiotics in the spasmodic period of whooping cough is indicated for the combination of whooping cough with acute respiratory viral diseases, bronchitis, bronchiolitis, in the presence of chronic pneumonia. One of the main tasks is the fight against respiratory failure.
The most responsible therapy for severe whooping cough in children of the first year of life. Oxygen therapy is necessary with the help of a systematic supply of oxygen, cleaning the airways from mucus and saliva. When breathing stops - suction of mucus from the respiratory tract, artificial ventilation of the lungs. With signs of brain disorders (tremor, short-term convulsions, increasing anxiety), seduxen is prescribed and, for the purpose of dehydration, 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 injected intravenously, to reduce pressure in the pulmonary circulation and to improve bronchial patency - eufillin, for children with neurotic disorders - bromine preparations, luminal, valerian. With frequent severe vomiting, parenteral fluid administration is necessary.
Antitussives and sedatives. The efficacy of expectorant mixtures, cough suppressants, and mild sedatives is questionable; they should be used sparingly or not at all. Cough-provoking influences (mustard plasters, jars) should be avoided.
For the treatment of patients with severe forms of the disease - glucocorticosteroids and / or theophylline, salbutamol. With apnea attacks, chest massage, artificial respiration, oxygen.
Prevention in contact with the sick
In unvaccinated children, human normal immunoglobulin is used. The drug is administered twice with an interval of 24 hours as soon as possible after contact.
Chemoprophylaxis with erythromycin at an age dosage for 2 weeks can also be carried out.
whooping cough vaccine
