Asthma In Children

WHAT YOU SHOULD KNOW:

• Asthma is a long-term condition of inflammation (irritation, redness, and swelling) in the airways of the lungs. The airways are small tubes where air passes through to go in and out of your child's lungs. An asthma attack (episode of asthma) usually happens after your child is exposed to triggers. Triggers are things that may cause your child's airways to react by getting smaller and becoming inflamed. Being around pets, dust, or smoke, or playing too hard are some things that may trigger asthma attacks. During an asthma attack your child's airways tighten, make too much mucus, and swell even more. A very bad asthma attack is known as an asthma exacerbation. With these attacks, your child's symptoms last longer and are more serious.
  
  
• Coughing, trouble breathing, and wheezing are the most common signs and symptoms of asthma. Your child may have a hard time doing physical activities. To find out if your child has asthma, his caregiver will ask about his symptoms and examine him. His caregiver may do tests for peak flow, pulmonary function, allergy and imaging tests. Your child's caregivers will teach you about your child's asthma, including how to control and treat it. They will give your child asthma medicines and teach him when and how to use them. Your child's medicines may be changed if his symptoms get better or worse. There is no cure for asthma, but the condition can be controlled and asthma attacks can be prevented.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

• Medicines for asthma can cause unwanted side effects. Medicines may make your child dizzy and increase his heartbeats. Some medicines, such as corticosteroids, can make him gain weight and can cause skin problems, such as acne. Your child may also be at risk of getting mouth infections, sore throat, hoarseness, and a hacking cough.
  
  
• Your child's asthma may get worse if it is left untreated or is not well controlled. He may have trouble doing his usual activities and miss many days of school. Your child may begin to have asthma attacks that come more often and last longer. He may get a very bad attack and need to be admitted to the hospital for treatment. If your child's airways get too tight and swollen, he may not get enough oxygen to his body. This may cause damage to his organs such as the heart and brain, and may cause death. Ask your child's caregiver if you have questions about your child's condition, medicines, or treatments.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

IV:

An IV is a small tube placed in your child's vein. Caregivers use the IV to give your child medicine or liquids.

Medicines:

Ask caregivers to tell you about the medicines that your child needs. He may need one or more of the following:

• Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  
  
• Short-acting bronchodilators: Short-acting bronchodilators may be given to your child to help open his airways. These medicines start to work right away and are used to relieve sudden, severe symptoms, such as trouble breathing. These medicines may be called relievers or rescue inhalers.
  
  
• Long-acting bronchodilators: Long-acting bronchodilators may be called controllers. This medicine helps open the airways over time, and is used to decrease and prevent breathing problems. Long-acting bronchodilators should not be used to treat your child for sudden, severe symptoms, such as trouble breathing.
  
  
• Leukotriene inhibitors: These medicines can decrease the swelling in your child’s lungs. They may stop your child from having more wheezing or shortness of breath. They may also prevent your child’s attacks from lasting for long periods.
  
  
• Mast cell stabilizers: Mast cells are found in the smaller tubes in your child’s lungs. They are in charge of releasing some chemicals that can cause your child’s airways to narrow. This kind of medicine may help prevent your child’s lungs from having more swelling.
  
  
• Corticosteroid medicines: Corticosteroid medicine may be given to decrease swelling and tightness in your child's airways. This helps him breathe easier. Your child may need this medicine when he is admitted into the hospital, and he may need more medicine if he has very bad asthma attacks.

Tests and monitoring:

• Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.
  
  
• Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.
  
  
• Chest x-ray: This is a picture of your child's lungs and heart. A chest x-ray may be used to check your child's heart, lungs, and chest wall. It can help caregivers diagnose your child's symptoms, or suggest or monitor treatment for medical conditions.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your child's skin record the electrical activity of his heart.
  
  
• Pulmonary function tests: These tests, also called PFTs, help your child's caregiver learn how well your child's lungs work. PFTs may also help your child's caregiver choose the best treatment for him. Your child may be given this test when he is old enough and can follow instructions. During the tests, your child will breathe into a mouthpiece connected to a machine. The machine measures how much air he breathes in and out over a certain period of time. This helps your child's caregiver to see how well your child's lungs are moving and working.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your child's blood. A cord with a clip or sticky strip is placed on your child's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your child's oxygen level is low or cannot be read.
  
  
• Vital signs: Caregivers will check your child's blood pressure, heart rate, breathing rate, and temperature. They will also ask you or your child about his pain. These vital signs give caregivers information about your child's current health.

Treatment options:

• Breathing treatments: Your child may need breathing treatments to help open his airways so he can breathe easier. A machine may be used to help your child breathe in medicine. A caregiver helps your child with these treatments.
  
  
• Oxygen: Your child may need oxygen if his blood oxygen level is lower than it should be. Oxygen will help your child breathe easier. Your child may get oxygen through small tubes placed in his nostrils, or through a mask. He may instead be placed in an oxygen tent. Never take off your child's oxygen tubes or mask or remove him from the tent without asking his caregiver first.
  
  
• ET tube: Your child may need an endotracheal (ET) tube to help him breathe. An ET tube is put in your child's mouth or nose, and goes into the trachea (windpipe). It may be connected to a breathing machine called a ventilator. The ET tube will be taken out when your child is breathing better.

Asthma action plan:

An action plan is the plan made by your child's caregiver for controlling your child's asthma. Keep a copy of this action plan with you and with your child at all times. Meet with your child's school nurses, teachers, coaches, and give them a copy of your child's action plan. Make a kit with a copy of the action plan and the medicines your child would need in case of an asthma attack. The plan should include the following:

• Early warning signs and symptoms: These are the early signs your child often shows when his asthma is starting to get worse. These may include a drop in your child's peak flow meter reading. Other signs, such as chest tightness, coughing, shortness of breath, and wheezing may also be included.
  
  
• Asthma triggers: The plan should include a list of triggers that may cause your child's asthma attack. This can help you and your child know which triggers to avoid.
  
  
• Medicines and dosage amount to give: The medicine information should include a list of all the medicines your child takes regularly to control his asthma. It should also include a list of rescue (quick-relief) medicines to give if your child has an asthma attack. It should also include instructions on how and when to use each medicine. Help your child use his medicines exactly as ordered by his caregiver.
  
  
• Treatment instructions for worsening symptom: These should explain what your child's symptoms may be and how to know if his asthma is getting worse. It should tell you how to increase his medicines if his asthma symptoms get worse. It should also tell you when you should call 911 or seek immediate care for your child.
  
  
• Emergency contact telephone numbers: These include the telephone numbers for you and your family members. This should also include numbers for your child's caregiver, an ambulance service, and the nearest hospital.
  
  
• When to follow up with your child's caregiver: Information about when to follow up with your child's caregiver should be easy to find. If you are not sure or this information is missing, ask your child's caregivers.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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