Asthma Emergencies In Children
Symptoms of an asthma attack can worsen and develop into an;asthma emergency. To prepare for an asthma emergency, make sure your childs doctor has written an;asthma;action;plan;for your child.;
Have a copy of your childs;asthma;action;plan pinned up somewhere easy to access at home, and send a copy to anyone who cares for your child, including their school, kinder, childcare service, family members and friends. You may like to take a photo of their;asthma;action;plan so you always have a copy with you.;
Get Help For Special Concerns
Special things to think about in treating asthma include:
- Managing exercise-induced asthma. Exercise often causes asthma symptoms. Steps you and your child can take to reduce the risk of this include using medicine immediately before exercising.
- Managing asthma before surgery. Children with moderate to severe asthma are at higher risk of having problems during and after surgery than children who do not have asthma. Before any surgery is done, make sure your child’s surgeon knows that your child has asthma.
- Taking care of other health problems. If your child also has other health problems, such as inflammation and infection of the sinuses or gastroesophageal reflux disease , he or she will need treatment for those conditions.
Know What To Do If Asthma Gets Worse
If your child’s asthma is not improving, talk with your doctor and:
- Review your child’s asthma diary to see if he or she has a new or previously unidentified trigger, such as animal dander. Talk to your doctor about how best to avoid triggers.
- Review your child’s medicines to be sure he or she is using the right ones and using them correctly.
- Review your child’s asthma action plan to be sure it is still right for his or her condition.
- Find out whether your child has a condition with symptoms similar to asthma, such as sinusitis.
If your child’s medicine is not working to control airway inflammation, your doctor will first check to see whether your child is using the inhaler correctly. If your child is using it correctly, your doctor may increase the dosage, switch to another medicine, or add a medicine to the existing treatment.
If your child’s asthma does not improve with treatment, he or she may require more treatment, including larger doses of medicines. An asthma specialist typically prescribes these medicines.
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Asthma Expert Professor John Price On The Questions To Ask
John Price, professor of paediatric respiratory medicine at Kings College London, answers the questions often asked by parents of children with asthma.
What do you think triggers my childs asthma?The triggers vary from child to child. In some children, colds trigger their attacks. In others, it can be exercise. Allergies may also be a big factor, and excitement, e.g. laughing and crying, may be another factor. Unfortunately, excitement at birthday parties is a well-known trigger of attacks.
Which treatments are available and how should my child take them? Some children should only take treatment when they wheeze. Others need to take treatment more regularly as a preventative measure, as well as when they wheeze. Children with persistent symptoms tend to need regular treatment to prevent asthma.
Where possible, your childs asthma should be treated with an inhaler. There are a couple of very good treatments that can be taken by mouth, but generally, the best treatments are taken with an inhaler. There are different inhalers for different ages, so ask your doctor or nurse which type of inhaler is most appropriate for your child.
Are the treatments safe? Largely, the treatments taken to relieve wheezing are very safe. The most commonly taken treatment is an inhaled steroid. If this is taken in a large dose, it can have side effects. If you’re worried about the dose your child is taking, talk to your doctor or nurse.
What Makes A Child More Likely To Develop Asthma
There are many risk factors for developing childhood asthma. These include:
- Family history of asthma, allergies and atopy .
- Frequent respiratory infections.
- Being African American.
- Being raised in a low-income environment.
In children who are under five years of age, the most common cause of asthma symptoms is upper respiratory viral infections such as the common cold.
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Causes And Triggers Of Asthma
Asthma is caused by swelling of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow.
It may happen randomly or after exposure to a trigger.
Common asthma triggers include:
- smoke, pollution and cold air
- infections like colds or flu
Identifying and avoiding your asthma triggers can help you keep your symptoms under control.
Asthma As A Global Disease
Asthma has clearly shown to be a global disease, however in last two decades was defined as a real public health problem affecting countries from all over the world and population of all age groups . However, there are differences among countries, with rates significantly above the average, for example, in some native English-speaking countries and, in contrast, much lower-than-average prevalence rates in some African and Asian countries .
Upon the first epidemiological publications on asthma, it was noted that asthma prevalence was higher in social classes with a high or very high annual income and that asthma severity was higher among the most disadvantaged. However, the latest epidemiological data from Africa, Latin America and Asia, showed that, in areas with low economic development, asthma prevalence has been increasing . Although there could be several explanations, the development of larger cities, with consequent reduction of rural areas, may have played a role. With most the world population living in urban areas, the environmental conditions as the lifestyle changes have certainly influenced the asthma prevalence rate increase .
Consequently, it can be said that asthma, worldwide, is globalized and affect all countries as a public health problem.
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What Can I Do To Reduce Asthma Symptoms
- Learn your childs triggers.
- Allergens like dust mites, pets, pests, molds and pollen can play a role in some childrens asthma.; Discuss with your health care provider whether an evaluation by an allergist may be helpful.
- Follow your asthma management plan and give the medicines prescribed by your childs doctor.
- Avoid smoking near your child.
Can A Child Outgrow Asthma
Once someone gets sensitive airways, they stay that way for life. This is the case even though asthma symptoms can change over the years. As a child gets older, they may be able to handle airway inflammation and irritants better, so their symptoms may get better. About half of those children get asthma symptoms again when they are in their late 30s or early 40s. There is no way to know which children may have reduced symptoms as they get older. New triggers may set off symptoms at any time in people who have asthma. If your child has asthma, keep quick-relief medicines and their Asthma Action Plan on hand , even if symptoms dont happen often.
Medical Review September 2015.
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What Causes Asthma In Infants And Toddlers
We still do not know what causes some people to get asthma. If a child has a family history of asthma or allergies, a specific allergy or had a mother who smoked during pregnancy, they have a higher chance of getting asthma early in life.
A respiratory virus, an illness that occurs in the lungs, is one of the most common causes of asthma symptoms in children 5 years old and younger. Although both adults and children experience respiratory infections, children have more of them. Some preschool children get viral infections often. At least half of children with asthma show some sign of it before the age of 5. Viruses are the most common cause of acute asthma episodes in infants 6 months old or younger.
Can Toddlers Get Asthma
Many infants and toddlers may wheeze when sick with a viral illness, such as cold or flu. But most of these children dont get asthma later in life. Some children with persistent wheezing and asthma get better during the teen years. About half of the children who have asthma at a young age seem to outgrow it.
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Global Alliance Against Chronic Respiratory Diseases
The Global Alliance against Chronic Respiratory Diseases contributes to WHOs work to prevent and control chronic respiratory diseases. GARD is a voluntary alliance of national and international organizations and agencies from many countries committed to the vision of a world where all people breathe freely.
When To See A Gp
See a GP if you think you or your child may have asthma.
Several conditions can cause similar symptoms, so it’s important to get a proper diagnosis and correct treatment.
The GP will usually be able to diagnose asthma by asking about symptoms and carrying out some simple tests.
Find out more about how asthma is diagnosed.
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Who Should Treat This Particular Aspect Of Asthma Or Allergies
Many older patients are treated for asthma by their internist or family physician; however, if your asthma symptoms are not under control within three to six months, or if you have severe persistent asthma, or if you are having asthma episodes that need emergency treatment, it may be time to see an asthma specialist. Allergists/Immunologists or pulmonologists are specialists who treat asthma. Those who have completed training in those specialties are usually called board-certified or board-eligible.
Effect On Your Child’s Life
Loss of lung function in asthma appears to start early in childhood. Asthma also may increase the risk of a partial collapse of lung tissue or a collapsed lung .
Sometimes asthma does not respond to treatment because children are not taking their medicines or are not taking them correctly, are not avoiding triggers, and are otherwise not following their asthma action plan. It is very important that you and other caregivers make sure your child is following his or her action plan to keep asthma from getting worse and to reduce the risk of death from asthma.
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Data Analysis And Presentation
Immediately after each session, the audiotapes were transcribed and analyzed by the researchers, thus providing the opportunity to detect gaps, reveal unclear comments, and facilitate the rolling interview guide for the upcoming session of the same focus group. This approach provided the moderators with essential information from the previous sessions and recommendations for the upcoming session. Two reviewers independently coded all statements of the children concerning components of HRQL. Some statements were coded twice, because they provided information on more than one component. When a child emphasized a particular component for the second time, this statement was coded again. Consequently, we were able to calculate the total number of statements per code. In case of discordance between the two reviewers, a third reviewer was consulted.
The outcome of the NGT was used to weigh the importance of the finally identified components. The components that had been labeled as the most important for the children received 3 points, the second-most important component received 2 points, and the third-most important component received 1 point. A total score per component was calculated.
Concern About Medicines And Growth
Some parents worry that children who use inhaled steroid medicines may not grow as tall as other children. A very small difference in height and growth was found in children using inhaled steroid medicines compared to children not using them.footnote 11 And one study showed a very small difference in height in adults who used inhaled steroid medicines as children compared to adults who did not use these medicines.footnote 12 But the use of inhaled steroid medicine has important health benefits for children who have asthma. If you are worried about the effects of asthma medicines on your child, talk with your doctor.
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What Are The Signs And Symptoms Of Asthma In Children
Signs and symptoms of asthma in children include:
- Frequent coughing spells, which may occur while the child is playing, laughing, or at night or right after waking. Coughing may be the only symptom.
- Less energy during play.
- Complaint of chest tightness or the chest “hurting.”
- Whistling sound when the child is breathing in or out.
- Retractions in the chest from difficulty breathing.
- Shortness of breath or loss of breath.
- Tightened neck and chest muscles.
- Feelings of weakness or tiredness.
Not all children have the same asthma symptoms. Symptoms can vary from episode to episode in the same child. In addition, not all wheezing or coughing is caused by asthma.
If your child has problems breathing, take him or her to the pediatrician for an evaluation. Your child may be referred to a specialist, such as a pediatric pulmonary provider or a pediatric allergist.
Emotional And Mental Impact
The children emphasized that they felt different from peers. Medication use was a negative aspect of asthmatic disease that was frequently mentioned. However, the interviewed children were thinking rather positively about the future. They expected that improved medication might become available in the future, that bullying would develop to be less frequent at high school, and hoped that they would outgrow the disease like they had heard from some people. The most frequently mentioned cognitive complaint was the lack of concentration in school. Coughing, in particular, was found to disturb their concentration.
Illustrative quotes regarding emotional and mental impact
“No, because when I get out of bed like that, and then I have to take medicine and then I’m like, yeah then I sometime, I really don’t want to, but I do have to. And that takes a while. And when I have to, I say to myself , only when I don’t have to, then I’d be happy. Because sometimes in class, I have to cough, but not often, but it’s not nice. Uh yeah.”
“Well sometimes I feel a bit different when I suddenly have trouble with my lungs.”
” Yes and when they bully you now, WHEN, the pushing when you can’t run so fast, when you’re older it won’t be like that.”
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Create An Asthma Action Plan
Both adults and children need to create an asthma action plan to outline what type of medicine they should take and when. It will also provide details for what to do when a persons asthma is dangerously out of control. These instructions will help you, your child, friends and relatives know when its time to change treatments or seek emergency care.
To make this plan, discuss your treatment options with your doctor. Plan what you should do in the event of an asthma flare-up. Define at what point you need to increase treatment measures to prevent or reduce an attack.
List what triggers can be avoided and the best ways to avoid them. Share this plan with friends, relatives, and any caregivers your children may have. Together, you will be able to successfully treat your or your childs asthma and avoid future complications.
How Is Asthma In Children Treated
Based on your child’s history and how severe the asthma is, the healthcare provider will develop a care plan called an “Asthma Action Plan,â which describes:
- When and how your child should use asthma medication.
- What to do when asthma gets worse.
- When to seek emergency care for your child.
Make sure you understand this plan and ask your child’s provider any questions you may have. The Asthma Action Plan is important to the success of asthma control. Keep it handy to remind you of your child’s daily asthma management plan and to guide you when your child develops asthma symptoms. In addition to following the Asthma Action Plan, try to limit exposure to asthma triggers.
Asthma medications that adults and older children take can also safely be prescribed for toddlers and younger children. In the case of inhaled medications, a different delivery device based on the child’s age and ability may be required.
If your infant or child is having asthma symptoms that require treatment with a rescue inhaler more than twice a week, your provider may prescribe a daily controller therapy .
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Physical Symptoms Of Asthma
Asthma symptoms and severity vary substantially from person to person. Most people with asthma do not have symptoms constantly. Bothersome asthma symptoms can mean that asthma is not controlled sufficiently or that an acute asthma episode may be starting. Common asthma symptoms include:
- Shortness of breath
- Awakening in the night from coughing or wheezing
If you do not have asthma, you can help yourself imagine what it feels like to have an asthma episode:
How Many School Days Does Asthma Affect
A study from Johns Hopkins Advanced Studies in Medicine found that asthma impairs patients well-being and can significantly interfere with the ability to undertake normal daily activities. In 2002 in the United States, adults missed 11.8 million workdays and children 5 to 17 years old missed 14.7 million school days because of their asthma.
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