La tosse nel bambino
La tosse in età pediatrica rappresenta un problema molto comune.
Si stima che nel periodo invernale almeno il 30% dei bambini assuma ripetutamente prodotti per la cura della tosse.
In base alla sua insorgenza si distingue tra una tosse acuta e la tosse cronica o ricorrente.
TOSSE CRONICA O RICORRENTE
Spesso i genitori raccontano di bimbi che tossiscono in continuazione, anche per periodi molto lunghi.
In realtà le fastidiose tossi ricorrenti colpiscono prevalentemente i bambini delle prime classi della scuola materna, che sono particolarmente recettivi per i virus invernali, che causano un'infiammazione delle strutture faringo-tracheali (faringo-laringo-tracheite).
In base alle sue caratteristiche si distingue una
- Tosse secca senza produzione di muco
- Tosse grassa con abbondante produzione di muco
Tra i fattori predisponenti per una suscettibilità alla tosse va sicuramente considerato l'inquinamento atmosferico da parte di polveri sottili; sicuramente i bambini di città, che vivono in contesti particolarmente inquinati e respirano un'aria di pessima qualità, a parità di altri fattori di rischio, sono più svantaggiati.
La tosse, come già detto, é il sintomo di una patologia non é la patologia stessa.
Vediamo quindi quali variabili vanno considerate nei pazienti che presentano tossi croniche o ricorrenti
Nelle tossi croniche vanno considerate
- Presenza di una patologia allergica
- Asma
- Sindrome da Ipereccitabilità dei Recettori della Tosse (S.I.R.T.) dovuta ad un surriscaldamento dei sensori tracheo- bronchiali.
- Tosse da Sindrome Sinu-bronchiale (tosse dovuta ad una sinusite)
- Tosse da sindrome da reflusso gastro-esofageo (GERD)
- Tossi da bronchite cronica
Visto che la tosse é soltanto il sintomo di una patologia, per avere buone prospettive di successo in bambini che presentano tossi croniche e ricorrenti occorre evitare terapie generiche (come gli sciroppi sedativi della tosse) cercando di identificare la causa del problema per poi trattarla in maniera specifica.
In generale occorre ricordare che una buona prevenzione invernale mirata, cioè adeguata alla situazione del singolo bambino (presenza di adenoidite? sinusite? rinite cronica?), sarà di sicuro aiuto per alleviare la maggior parte delle tossi invernali.
TOSSE ACUTA
La crisi di tosse improvvisa può manifestarsi in maniera violenta ed improvvisa, destando molta preoccupazione nei genitori.
Come comportarsi:
-
In caso di tosse grassa non utilizzare per alcun motivo i sedativi della tosse. Tali farmaci spengono il riflesso nervoso e fanno scomparire il sintomo, tuttavia, la mancata espulsione del catarro dai polmoni può facilmente causare un ristagno, che culmina in un focolaio broncopolmonitico, molto pericoloso.
-
Non somministrare dosaggi eccessivi di mucolitici poiché, superato un certo livello, fluidificando il catarro ne aumentano il volume creando ulteriori problemi meccanici
- Nella tosse secca non eseguire inalazioni con oli aromatici che, specialmente nei bambini piccoli, possono causare forti reazioni broncospastiche e, quindi serie difficoltà di respirazione
-
Calmare il bambino.
-
Fargli respirare del semplice vapore acqueo.
-
Non stenderlo ma tenerlo in braccio o semiseduto, per evitare una congestione a livello polmonare
-
Liberare il naso dalle secrezioni cercando di ottimizzare la respirazione fisiologica.
Se la tosse dovesse persistere per alcuni giorni sarà opportuno fare controllare il bimbo per escludere processi infettivi maggiori.
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