Acute Respiratory Infections in Children: Effective Management and Care

Acute respiratory infections are a common occurrence in children, especially during seasonal changes. These infections, caused by bacterial or viral agents, affect the entire respiratory system, including the ears, nose, throat, and lungs. Prompt and appropriate care is essential to ensure the comfort, speedy recovery, and prevention of complications in children affected by acute respiratory infections.

Understanding Acute Respiratory Infections in Children: Acute respiratory infections encompass a range of bacterial or viral diseases that result in acute inflammatory conditions in the respiratory system. These infections typically manifest as a cough lasting no more than 30 days. 

Among children under the age of 5, acute respiratory infections are the leading cause of mortality. It is estimated that children in this age group may experience these infections 5 to 8 times annually. While most children recover within 10-14 days with proper care, approximately 20-25% of cases can progress to pneumonia, a severe complication leading to mortality in developing countries.

There are two types of acute respiratory infections: 

a. Upper respiratory tract infections: These affect the ear, nose, and throat and are usually caused by viral agents. With appropriate care, most children recover without complications. 

b. Lower respiratory tract inflammation: This includes conditions such as bronchiolitis and pneumonia, with pneumonia being the most critical and life-threatening. Early diagnosis of pneumonia is crucial to ensure timely treatment and prevent complications and fatalities.

Management and Care:

Children with Common Signs: When a child presents with symptoms such as cough, common cold, fever, runny nose, mouth breathing, and normal breathing, parents should not be overly alarmed as these conditions usually resolve within 2 weeks. Since these cases are predominantly viral, antibiotics are not effective. 

Parents can provide home care and treatment using the following steps:

• Herbal cough remedies, such as white rose or steamed kumquat with honey, can be used for persistent coughing.

• Clean the child's nose and mouth using 9% saline solution. Dilute nasal secretions by instilling saline drops in each nostril and then remove the secretions using a nasal aspirator.

• Help the child cough and expel phlegm effectively by gently patting their back. This can be done before meals or 1 hour after eating to avoid vomiting. Cup your hand and pat the left and right side of the back for about 3-5 minutes in each area.

• Increase breastfeeding frequency. If breastfeeding is challenging, expressed breast milk can be fed to the child using a spoon.

• For non-breastfed babies, provide age-appropriate cow's milk formula.

• Offer nutrient-rich, easily digestible foods such as rice porridge with meat or eggs, beans, green vegetables, and healthy fats.

• Divide meals into smaller portions throughout the day to ensure adequate nutrition and stimulate appetite.

• Provide fruit juice to supplement vitamins and replenish fluids lost due to fever.

• Monitor the child's temperature with a thermometer. If the temperature is between 37.5 to less than 38.5 degrees Celsius, remove excess clothing, use a warm washcloth on the forehead, armpits, and groin, and administer appropriate fever-reducing medication.

• Limit exposure to disease transmission, maintain cleanliness in the living environment, clean caregiving tools, and keep the child in a well-ventilated area while ensuring proper hygiene.

Children with Severe Signs:

In cases where a child exhibits severe signs such as prolonged cough, rapid or labored breathing, difficulty breathing, poor feeding, inability to drink, foaming at the mouth, fatigue, and chest tightness, it may indicate pneumonia, a severe and dangerous complication. In such cases, parents should first count the child's breaths per minute while the child is lying still. 

Tachypnea (rapid breathing) is indicated by:

• Breathing rate over 60 breaths per minute for infants under 2 months old.

• Breathing rate over 50 breaths per minute for infants aged 2-12 months.

• Breathing rate over 40 breaths per minute for children aged 12 months to 5 years.

When visiting a medical center, doctors will perform a clinical examination and conduct various paraclinical tests to diagnose pneumonia in children. Key symptoms for clinical diagnosis and assessing the severity of the disease include fever, cough, rapid breathing, and chest indrawing. Paraclinical tests prescribed by the doctor may include:

• Blood tests: A complete blood count can identify signs of infection, such as increased white blood cell count. Blood cultures may be performed to identify the bacteria causing the infection, aiding in selecting appropriate antibiotic treatment.

• Urine test: A urine antigen test can help diagnose pneumonia caused by specific bacteria such as Streptococcus pneumoniae and Legionella pneumophila.

• Chest X-ray: X-ray imaging of the chest confirms the diagnosis and helps determine the location, cause, and severity of pneumonia.

• Sputum culture: Collecting sputum from a deep cough allows laboratory testing to identify the bacteria causing the illness and guide antibiotic treatment selection.

• CT scan: In severe cases or when treatment has not been effective, a CT scan provides detailed images of the lungs, aiding in diagnosis and treatment evaluation.

• Pulse oxygen saturation measurement: This non-invasive test using a pulse oximeter helps assess oxygen levels in the blood, which can be affected by pneumonia.

• Arterial blood gas analysis: This test measures oxygen and carbon dioxide levels in arterial blood, providing information about gas exchange and the severity of the disease.

• Bronchoscopy: In cases of severe pneumonia or unresponsiveness to antibiotics, bronchoscopy may be performed to directly visualize the airways, collect fluid or tissue samples, and determine the cause of the infection.

With the availability of modern equipment and sterile environments, medical centers can minimize the risk of disease transmission and ensure a comfortable experience for children during diagnostic procedures. Experienced pediatric healthcare professionals provide dedicated care and support, alleviating concerns for parents.

Preventing Acute Respiratory Infections in Children:

Prevention plays a crucial role in reducing the incidence and severity of acute respiratory infections in children. Some preventive measures include:

• Early initiation of breastfeeding after birth.

• Adhering to the recommended vaccination schedule.

• Providing a balanced diet that strengthens children's immune systems.

• Ensuring children reside in well-lit, ventilated, and clean environments.

• When using air conditioning, maintaining a temperature difference of 5-7°C between indoor and outdoor environments to aid in adaptability for children.

• Keeping children warm and protecting them from smoke, dust, tobacco, air pollution, and cold air.

• Isolating adults with respiratory illnesses to prevent transmission to children and maintaining proper hand hygiene before and after caring for children.

Conclusion: Acute respiratory infections in children encompass a range of bacterial or viral diseases affecting the respiratory system. Timely management and care are essential to facilitate a child's recovery and prevent complications. 

Recognizing the signs, providing appropriate home care for mild cases, and seeking professional medical attention for severe cases can ensure the well-being of children with acute respiratory infections. Upper respiratory tract infections, typically caused by viruses, usually resolve on their own with home care. 

However, lower respiratory tract infections such as pneumonia can be severe and require prompt diagnosis and treatment.