Asthma is the leading cause of ER visits and hospitalizations in children!
Isn’t that amazing? Since many asthma exacerbations are caused by allergies, we think that it is a good time to review key information about asthma and how we treat it. Let’s start with the basics:
What is asthma?
- Airway hyper-responsiveness
- Excessive mucous production
- Chronic inflammation
These 3 things cause many different symptoms, such as cough, wheezing, shortness of breath, chest tightness.
What treatments are recommended for asthma?
One of the best treatments for asthma is to avoid known triggers! For example, if your child’s trigger is pollen, he may need to take an allergy medicine daily to reduce the risk of asthma attacks. If a trigger is smoke, eliminate passive smoke exposure.
The two classes of medications used to treat asthma are “control” medicines and “rescue” medicines.
A control medication is taken every day to achieve and maintain control of persistent asthma. These help decrease the frequency of asthma attacks. Inhaled steroids are the first line of treatment in this category of medication. (Some common medications: Budesonide (Pulmicort) or Flovent). Inhaled steroids are directed right into the airways to reduce inflammation and decrease mucous production. If your child is having symptoms more than 2 times per week, or has symptoms that keep him up at night, we will likely recommend starting a control medication.
A rescue medication such as Albuterol or Xopenex is used as needed for quick relief of symptoms. Rescue medications relax the airway muscles to relieve constriction and make breathing easier.
We will work with you to develop an Asthma Action Plan individualized for your child. A plan can:
- Provide a guideline for daily management
- Help you recognize and manage worsening asthma.
What is an “asthma attack?”
It is a spasm of the airway muscles, causing constriction. You may hear wheezing or see other signs of difficulty breathing like panting, flaring nostrils, or visible ribs when breathing. Your child might complain of difficulty catching his breath or chest tightness, or might not be able to finish a full sentence without pausing to catch a breath.
Each child has different triggers. Upper respiratory infection is the number one cause of asthma exacerbation. Other common triggers include environmental irritants (like pollen, smoke, dust), exercise, and cold air.
For an asthma attack, remove potential triggers and give a rescue medication such as Albuterol or Xopenex.
Call our office (or on-call physician after hours) or go the ER if your child is having an asthma attack and has only partial relief from rescue medication!
Beyond the basics
If your child’s symptoms are not well managed, we may refer you to a pulmonologist. Many pulmonologists in this area can provide Pulmonary Lung Function testing (PFTs) to determine your child’s lung volumes and capacity. They will use this information, as well as your child’s asthma history, to determine optimal asthma management.
For more information you can review the NIH guidelines on asthma management.