Advice: Asthma

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Asthma

Asthma basics

Asthma is a chronic condition that causes inflammation and swelling in the tubes that carry air to the lungs
Symptoms include wheezing, coughing (especially overnight), chest tightness, or shortness of breath, and they can change in severity over time or from child to child.
Some children only have asthma symptoms when they have a respiratory infection like a cold; others only have symptoms during exercise, or when they are exposed to triggers like dust, smoke, cockroaches, mold, animals, or pollen.
Other children have symptoms more regularly, or may have such significant symptoms that they require treatment with steroids or hospitalization.
A child who has asthma symptoms more than twice a week or needs multiple courses of steroid treatments in a year may require a daily breathing treatment to help prevent asthma attacks.
There is no cure for asthma, but there are ways to prevent and treat symptoms

Prevention

Avoid triggers like tobacco or pollutants
Control exposure to allergens if needed (ie, air purifiers, dehumidifiers, allergy-proof covers on bedding and frequent washing, limiting outdoor exposure in peak pollen season, vacuum carpets regularly)
If your child’s symptoms occur with exercise, your medical team may recommend using albuterol (a quick relief medication) 20-30 minutes before exercise
Help your child learn to manage stress and anxiety

Treatment

"Rescue" or quick-relief medications" Medications like albuterol nebulizers or inhalers, provide rapid relief of symptoms. Usually, albuterol can be used every 4 hours (children needing it more frequently should go to the ER). Albuterol should be used for any symptoms, not just during an asthma “attack”
“Controller” medications: Medications like Pulmicort nebulizers or Flovent or Symbicort inhalers, are usually used to prevent symptoms from happening in children with more persistent symptoms. These may be used once to twice a day even when the child is well; in younger children sometimes these types of medicines are only used when the child is sick for a week or t
Oral steroids: Medications like prednisone or dexamethasone may be used if a child is having more significant asthma symptoms as part of an exacerbation
Allergy Medications: If your child’s asthma symptoms are related to allergens like pollen or animals, they may also benefit from antihistamines like Zyrtec or Allegra

When to seek care

If and when you are instructed by your provider. Some children will need to be seen to check symptoms and/or receive another dose of medication after an asthma visit. Other children will need to be followed regularly by their Pediatrician for long-term treatment.
If your child has increased work of breathing: breathing harder, breathing faster, or having difficulty catching their breath.
If symptoms are worsening or albuterol doesn’t seem to last the full 4 hours
If symptoms last more than 2-3 days.
If you are concerned

When to go to the Emergency Departent

If your child is in respiratory distress (nostrils flaring, ribs showing, significant belly breathing, head bobbing, grunting, or very fast breathing)
If your child is needing albuterol every 2 to 3 hours or more
If your child is lethargic or difficult to arouse
If your child is showing signs of severe dehydration: lethargy, little/no urine output, dry lips, sunken fontanelle (soft spot)
If you are worried

Additional Resrouces

Potomac Pediatrics will always be fully focused on helping your child and you to overcome any healthcare hurdle, with innovative, comprehensive and compassionate care.