Asthma is the most common chronic disease that affects school-age children. It is recorded that about 7 million children in America are affected by this disease. Asthma is a condition in which inflammation causes the airways to narrow making it difficult to breathe. In addition, sufferers also experience periodic "attacks" which indicate worsening symptoms. Asthma must be treated as soon as possible because it can progress to a more serious illness and even death. Therefore, parents must recognize asthma attacks that occur in children as soon and as accurately as possible.
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Part 1 of 4: Listening to Children
Step 1. Pay attention to the child's complaint of difficulty breathing
Children who are somewhat mature or have had an asthma attack may sense an impending attack. If your child tells you right away that he or she "can't breathe" or is having trouble breathing, act on it! During the mild phase of an asthma attack, the child may experience wheezing, although in the more severe phase, wheezing may not necessarily occur.
Step 2. Take your child's chest pains seriously
Children who have asthma attacks may feel pain or tightness in the chest. Chest pain is common during an asthma attack because air is trapped in the narrowed airways, increasing the pressure in the chest. You may also notice a reduction in breath sounds due to obstruction of the airway.
Step 3. Know your child's limits
Young children or those who have never had an asthma attack may have difficulty describing or reporting shortness of breath or chest pain. Instead, the child may panic and describe it in ambiguous terms, such as "I feel bad" or "it hurts." Watch your child with asthma carefully for signs of an asthma attack, such as shortness of breath or wheezing. Don't assume that if your child doesn't report shortness of breath or chest pain, it doesn't mean the child has an asthma attack.
Step 4. Check the child's respiratory rate
Infants and young children (children up to 6 years of age) have a higher metabolic rate. Therefore, the respiratory rate is also getting higher. Children at this age are not yet able to report symptoms of an asthma attack well, so pay close attention to the child's breathing. Any abnormality when breathing requires further attention from parents. Children's breathing rates vary widely, but the general guidelines are as follows:
- Infant (from birth – 1 year) 30–60 breaths/minute
- Toddlers (1–3 years) 24–40 breaths/minute
- Kindergarten (3-6 years old) 22–34 breaths/minute
Step 5. Be aware of natural triggers for asthma attacks
Most children begin to show symptoms of a reaction to an asthma attack trigger (asthma trigger) at the age of 5 years. An asthma attack trigger is anything that causes asthma symptoms to increase. Triggers vary from child to child, so be on the lookout for things that can trigger an asthma attack in your child, especially if you suspect an attack is imminent. Some triggers (such as dust or pet dander) can be cleaned up, but others (such as air pollution) can only be monitored as best they can. Asthma triggers in general are the following:
- Pet dander: use a vacuum cleaner or mop with a damp cloth to regularly clean the hair loss.
- House dust: use a mattress and pillowcase to protect your child from dust. Wash sheets regularly and don't put dolls in your child's room. Also, avoid pillows or bolsters that contain feathers.
- Cockroaches: Cockroaches and their droppings are a common trigger for asthma attacks. To keep cockroaches out of your home, don't just leave food and drinks open. Sweep up all crumbs and food particles immediately, and clean the house regularly. Consult with professional midges.
- Moss: Moss grows in the presence of moisture, so use a hygrometer to check the humidity of your home environment. Use a humidity control device to prevent mildew in the house.
- Smoke: any type of smoke can trigger an asthma attack. Even if you go outside to smoke, traces of smoke on clothes and hair can still harm your child.
- Certain foods: eggs, milk, nuts, processed soy, wheat, fish, shellfish, salads, and fresh fruit are known to trigger asthma for children who are allergic to these foods.
- Air pollution and extreme weather changes.
Step 6. Monitor the child's behavior
Perhaps, simply avoiding the trigger of the attack wasn't enough. When children feel very emotional, for example sad, happy, afraid, and so on, they are prone to asthma attacks. In addition, excessive exercise can also make children short of air and take deep breaths, triggering an asthma attack.
Step 7. Take good care of your child's respiratory infection
Bacterial or viral infections of the upper and lower respiratory systems can trigger an asthma attack. Make sure your child is evaluated by a pediatrician if they show symptoms of a respiratory infection. Your doctor may give you medication to control the symptoms of the infection so that it subsides quickly.
Be wary of antibiotics used to treat bacterial infections. Viral infections of the respiratory system may require an approach from a management rather than a treatment perspective
Part 2 of 4: Evaluating a Child's Breathing
Step 1. Notice if the child is breathing rapidly
The normal respiratory rate for adults is no more than 20 breaths per minute. Depending on their age, children may have a faster resting respiration rate. It's a good idea to be aware of all the common symptoms of unnaturally rapid breathing.
- Children aged 6-12 years usually have 18-30 breaths per minute.
- Children 12-18 years usually have 12-20 breaths per minute.
Step 2. See if the child is having trouble breathing
Children who breathe normally primarily use the diaphragm to breathe. Children who have asthma attacks, may use other muscles to take in air. Look for signs in your child's neck, chest, and abdominal muscles that are working harder than usual.
A child who is having trouble breathing may stoop down, with both arms clasped at the knees or the edge of the table. If you recognize this posture, your child may be having an asthma attack
Step 3. Listen to the child's voice
Children who have asthma attacks often make a low whistling sound and vibrate when breathing. This is because air is forced through the narrowed airways when exhaling.
You may hear wheezing as your child inhales and exhales. Keep in mind, in a mild asthma attack or the onset of a severe asthma attack, wheezing is only heard when the breath is exhaled
Step 4. Notice if the child is coughing
Asthma is the leading cause of chronic cough in children. Coughing causes the pressure in the respiratory tract to increase. Therefore, the respiratory tract is forced open and air can flow temporarily. So, even if it helps your child's breathing, coughing is a sign of a more serious problem. Children may also cough as their bodies try to ward off environmental triggers for asthma attacks.
- Coughing can also be a sign of a respiratory infection, which can trigger an asthma attack.
- Coughing that is persistent at night is a common symptom of mild or moderate persistent asthma in children. However, if the child coughs repeatedly for a long time, it may be an asthma attack.
Step 5. Look for retraction
Retractions are visible "pulling" between and just below the ribs or collarbones when the child is breathing. This occurs because the muscles work hard to draw in air, but the air cannot enter quickly because the passage is blocked.
If the retraction between the ribs seems mild enough, take your child to the doctor as soon as possible. If retractions appear moderate or severe, call for emergency assistance
Step 6. Check for dilated nostrils
When the child is struggling to breathe, it can be noticed that his nostrils will widen. These signs are especially useful when looking for symptoms of an asthma attack in infants and very young children. Children at that age will not be able to tell symptoms or bend over like other children who are older.
Step 7. Monitor the child's “silent chest”
If your child seems to be suffering but you don't hear any whining, your child may have a "silent chest." This occurs in some cases, when the airways are so blocked that there is not enough air to produce wheezing. “Silent chest” should be given emergency medical attention immediately. The child may be so exhausted from all the effort to breathe that he can neither expel carbon dioxide nor inhale oxygen.
Another symptom that indicates a child is not getting enough oxygen and needs emergency help is that the child cannot pronounce a full sentence
Step 8. Use the Peak Flow Meter tool to determine the severity of an asthma attack
This tool is simple and is used to measure the “peak expiratory flow rate (PEFR). Measure daily to find out your child's normal PEFR. Abnormal measurement results signal early symptoms and help you predict an asthma attack. The normal range for PEFR depends on the age and height of the child. Talk to your doctor about the number in the “zone” and what action to take if your child is in the yellow or red zone. However, the general rule:
- 80-100% of a child's best PEFR score puts him in the “green zone” (small asthma attack risk)
- 50-80% of a child's best PEFR score puts him in the “yellow zone” (moderate risk of asthma attack, continue to monitor and administer medication prescribed by doctor for this zone)
- A PEFR score that is less than 50% of a child's best PEFR rate puts him in the "red zone" which means the risk of an asthma attack is very high. Give the child medicine for emergency help and seek medical attention immediately.
Part 3 of 4: Evaluating Children's Appearance
Step 1. Check the child's overall appearance
Children who suffer from asthma attacks are often clearly having difficulty breathing. Trust your instincts if you feel your child is having trouble breathing or there is a "problem" with the child. Give the inhaler or other emergency medicine prescribed by the doctor and seek medical attention immediately.
Step 2. Check for pale, damp skin
When a child has an asthma attack, his body is working hard just to breathe. As a result, the child's skin appears sweaty or damp. However, the skin will appear white or pale during an asthma attack, rather than the pink color of someone who has just finished exercising. Blood is red only when exposed to oxygen, so if the child is not getting enough oxygen, the pink color of the bloodstream will not be visible.
Step 3. Watch out for blue-tinged skin
If you notice a blue tinge to your child's skin, or if your child's lips and nails turn blue, the child is suffering from a serious asthma attack. The child is severely deprived of oxygen and needs emergency medical attention as soon as possible.
Part 4 of 4: Helping Children
Step 1. Give asthma medication
If the child has had an asthma attack, the child should have been prescribed asthma medication, perhaps in the form of an inhaler. Give medicine immediately when the child has an asthma attack. Although simple, if the inhaler is used incorrectly, its effectiveness will decrease. Here's how to use the inhaler correctly:
- Open the lid and shake vigorously.
- Do the test if needed. If the inhaler is new or has not been used for a long time, release a small amount of medication into the air before use.
- Have the child exhale fully, then take a deep breath as you give one spray of medicine.
- Ask the child to continue to inhale the air slowly and as deeply as the child can for 10 seconds.
- Always use a spacer or chamber that helps the medication enter the lungs instead of the back of the throat during use. Ask your doctor how to use the inhaler correctly.
Step 2. Check the inhaler label before administering the second dose of medication
The label on the medicine package will tell you how long it will take to wait before giving the second dose. If you are taking a 2-agonist such as albuterol, wait one full minute before giving the second dose of the drug.
Step 3. See if the medicine is working properly
Treatment results should appear one minute after using the inhaler. If no difference appears, give the medicine back to the child. Use the dose listed on the drug package label or follow your doctor's instructions (perhaps, the doctor will recommend that the drug be re-administered immediately). If the symptoms of an attack do not improve, seek medical attention immediately.
Step 4. Call your doctor if mild symptoms persist
Mild symptoms may include coughing, wheezing, or difficulty breathing. Call your pediatrician if the attack is mild, but the symptoms don't go away with medication. The doctor will probably treat your child at his or her clinic and give you some specific instructions.
Step 5. Go to the ER immediately if severe symptoms persist
A “silent chest” or blue lips and fingernails indicates the child is not getting enough oxygen. Children who have these symptoms should be treated immediately to prevent brain damage or death.
- If you have asthma medication for a child, give it on the way to the ER. However, don't delay bringing your child to the ER.
- Delayed emergency help during a severe asthma attack can lead to permanent brain damage and even death.
- Call an ambulance immediately if there is a blue color on the child's body and it does not get better even after being given medicine or the blue color has spread beyond the nails and lips.
- Call an ambulance if the child loses consciousness or has difficulty getting up.
Step 6. Call an ambulance if an asthma attack is triggered by an allergic reaction
If your child's asthma is triggered by a food allergy, insect sting, or medication, call an ambulance immediately. This type of reaction develops very quickly and can block the child's respiratory tract.
Step 7. Know the things that will be faced in the Emergency Unit room
The doctor will recognize the symptoms and signs of asthma. When the child arrives at the ER, the medical staff will provide oxygen if needed and may also give additional medication. If the asthma attack is severe enough, the child may be given corticosteroids via IV. Most patients will improve under expert supervision, and you should be able to take them home very soon. However, if the child's condition does not improve within a few hours, the child should be hospitalized.
