Pediatric emergency medicine trisk 1656 1656
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FIGURE 84.1 Approach to wheezing in children younger than 1 year. URI, upper respiratory
infection.
As indicated previously, the diagnosis of a chronic wheezing disorder, such as
asthma, relies on the identification of recurrent episodes of obstructive lower
airway disease. It is often useful to ask if the child has ever had “breathing
problems,” or has ever been treated with a “breathing medicine.” In a large
longitudinal study, major risk factors for asthma included eczema or a parental
history of asthma, and minor risk factors included wheezing between viral
illnesses, nonviral rhinitis, and eosinophilia. Cough, as a salient feature in patients
with obstructive lower airway disease, cannot be overemphasized (see Chapter 19
Cough ). In fact, in patients with cough-variant asthma, recurrent dry cough may
