Pertussis: Management and Complications (Pediatric Nursing)

00:01 Now, it's important to treat pertussis.

00:03 You have to treat it early and you have to treat it appropriately because this can progress rapidly in young infants, and you have to treat suspected cases promptly.

00:12 However, the treatment's ineffective if you start it late in the clinical course.

00:17 So, clinicians should start to consider pertussis in a patient with a strong clinical history.

00:23 And this will be patients at risk for severe or complicated disease, like infants.

00:27 So if a clinician diagnoses the patient late, the antibiotics aren't going to be helpful for the patient, at this point.

00:33 It may decrease their communicability and their ability to spread this onto other patients, but it's not actually going to help that patient.

00:41 So, treatment of pertussis includes antibiotics, typically the macrolide class, including erythromycin, clarithromycin, and azithromycin, if your patients are older than 1 month old.

00:52 For newborns <1 month old, azithromycin is the preferred agent.

00:57 Now, pertussis is a mandatory reportable condition to the health department.

01:01 This helps the local health department handle any outbreaks and treat households contacts and work contacts.

01:08 How do we treat this? We need to administer the course of antibiotics to the patient, and then also to the close contacts of the patient, including the household contacts, sometimes, school contacts, and sometimes, work contacts.

01:21 This needs to happen within 3 weeks of exposure before they actually develop their course of pertussis.

01:27 You use the same dose as in the treatment schedule.

01:30 Patients, you want to keep them hydrated.

01:32 They need to rest.

01:34 They need supportive oxygen at some point, and hospitalization is sometimes necessary in the younger population.

01:42 Pertussis can cause serious and sometimes, deadly complications in babies and young children, especially those who have not received all of their recommended pertussis vaccines.

01:51 About half of the babies younger than 1 who get pertussis need care in the hospital.

01:56 The younger the baby, the more likely they will need to be managed in the hospital.

02:01 Unfortunately, about 1 in 4 babies, about 23%, who are treated in the hospital with pertussis will develop a secondary pneumonia, which is an infection in their lungs.

02:12 Patients can also develop ear infections.

02:14 They can have seizures.

02:16 They can lose weight, and become dehydrated.

02:20 Patients can also get injuries from the severe coughing and the toll it takes on their body.

02:25 Some patients will crack ribs or develop hernias.

02:29 So, vaccines can prevent all of this.