1 / 11

Hands on Spirometry

Hands on Spirometry. Dennis R. Ownby, M.D. Chief, Section Allergy, Immunology, Rheumatology Georgia Health Sciences University Augusta, Georgia, USA. Case of New Onset Wheezing. 11 year old male with no prior history of asthma

eldora
Download Presentation

Hands on Spirometry

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Hands on Spirometry Dennis R. Ownby, M.D. Chief, Section Allergy, Immunology, Rheumatology Georgia Health Sciences University Augusta, Georgia, USA

  2. Case of New Onset Wheezing • 11 year old male with no prior history of asthma • Developed intermittent cough and persistent nasal congestion 1 month prior to admission • PCP started albuterol and fluticasone MDI 2 weeks prior to admission due to wheezing on exam • No improvement in symptoms with medications • Day of admission developed increased cough and dyspnea while in shower • In ED found to have inspiratory and expiratory wheezing and severe dyspnea

  3. Presentation to PICU • Wheezing continued to worsen despite continuous nebulized albuterol, plus IV magnesium and corticosteroids in ED • Transferred to PICU • Intubation strongly considered for respiratory difficulty • Symptom improvement with ketamine • Allergy-Immunology consulted for status asthmaticus

  4. Past Medical History • Full term, normal growth and development • Recurrent ear infections as infant-PE tubes placed • No history of atopic dermatitis, allergic rhinitis, pneumonia, or recurrent cough

  5. Past Medical History - Accident • Motor vehicle accident 2 months prior to admission • Sustained skull fracture, subdural hematoma, pulmonary contusion, scalp avulsion, clavicle and spine fracture • Hospital course complicated by polymicrobial scalp infection • Treated with multiple antibiotics and antifungals

  6. Past Medical History Accident • Surgeries: left craniotomy, T1-T3 spinal fusion, debridement of scalp laceration and skin graft • Intubated for four days, no respiratory difficulties after extubation • Normal mental status by discharge one month later

  7. Family History • 2 brothers have asthma and allergic rhinitis • No history of unusual infections or autoimmune disease in family

  8. Post-PICU Clinic Evaluation • Has felt well since leaving PICU • Resumed normal activity • No more wheezing or shortness of breath • Taking fluticasone from MDI • Has not needed albuterol MDI

  9. Spirometry Results

  10. Flow-Volume Loop

  11. Differential Diagnosis • Given the history and spirometry results what is the most likely cause of his recent wheezing episode?

More Related