How to Help Your Child With
Asthma
One out of every 10 children in the United States has asthma. Asthma is one of the main reasons children miss school and are admitted to the hospital. The number of children with asthma has increased in the last 10 years. As recent news reports have shown, there has been a rise in the number of children who die from asthma as well.
Asthma is a chronic disease of the passageways that carry air to the lungs. These airways become narrow and the linings become inflamed, irritated, and swollen. Children with asthma may be very sensitive to irritants such as viral infections, smoke (esp. cigarette), cold air, and particles or chemicals in the air. Asthma can also be caused by allergies to dust, animals, pollens, and molds. The inflammation and narrowing of the airways cause breathing to be labored, coughing, feelings of tightness in the chest, and shortness of breath. Cough may be the first and sometimes the only symptom of early asthma. Other symptoms are wheezing, fast breathing, difficult breathing that uses extra muscles from the neck, abdomen, and chest to help draw in air. Each person can have different symptoms. Need for medication varies from daily to just when symptoms appear.
One way to prevent or decrease asthma symptoms is to know when your child isn't getting enough air into the lungs. You can measure the amount of air your child can breathe in and out with the use of a simple device called a peak flow meter so that you can recognize if the airway is narrowing. The peak flow meter measures the amount of air flow in the airways or breathing tubes. The peak flow rate is the rate of air flow in the breathing tubes when a person inhales fully and blows the air out as quickly as possible. For the test to be useful, the person must be able to repeat the same flow rate at least three times on the same peak flow meter (there are many different kinds). Peak flow rates decrease when your child's asthma is getting worse or is out of control. Peak flow rates increase when the asthma treatment is working and the airways are opening up. The use of peak flow rate measurements can help you to recognize when your child's airway is narrowing, so asthma treatment can be started early. Peak flow rates also will help you identify some of the "triggers" for your child's asthma, so they can be avoided.
How can you tell if your child's asthma is getting worse?
* Asthma symptoms such as cough, wheeze, chest tightness, shortness of breath occur more frequently and/or get worse
* Large decreases in your child's peak flow rate occur
* Asthma medications do not seem to help your child's cough or breathing problem
* You frequently have to go to the doctor or ER for treatment of acute asthma
* Your child is admitted to the hospital for asthma treatment
* Your child is admitted to a hospital intensive care unit for treatment
* Large changes in peak flow rate measurements occur (more than 20% change between morning & evening
* Your child's asthma symptoms increase; symptoms occur more often at night & awaken the child from sleep
* Your child's asthma attacks last longer and do not easily improve with treatment
* Special oral anti-inflammatory medications such as steroids are needed more often to control the asthma
* Your child's asthma attacks become quite severe
* Your child has panic attacks with severe confusion and anxiety with the asthma attacks
It is important to work with your pediatrician to develop a plan of action that is specific to your child:
* How to prevent or reduce asthma symptoms
* How to recognize asthma symptoms, especially symptoms of worsening asthma
* How to recognize what triggers your child's asthma so you can reduce asthma attacks
* What treatment should be administered first and what to do if asthma becomes worse
* What to do in an emergency
Prevention and early treatment may help reduce the number of days your child misses school or is hospitalized.
One out of every 10 children in the United States has asthma. Asthma is one of the main reasons children miss school and are admitted to the hospital. The number of children with asthma has increased in the last 10 years. As recent news reports have shown, there has been a rise in the number of children who die from asthma as well.
Asthma is a chronic disease of the passageways that carry air to the lungs. These airways become narrow and the linings become inflamed, irritated, and swollen. Children with asthma may be very sensitive to irritants such as viral infections, smoke (esp. cigarette), cold air, and particles or chemicals in the air. Asthma can also be caused by allergies to dust, animals, pollens, and molds. The inflammation and narrowing of the airways cause breathing to be labored, coughing, feelings of tightness in the chest, and shortness of breath. Cough may be the first and sometimes the only symptom of early asthma. Other symptoms are wheezing, fast breathing, difficult breathing that uses extra muscles from the neck, abdomen, and chest to help draw in air. Each person can have different symptoms. Need for medication varies from daily to just when symptoms appear.
One way to prevent or decrease asthma symptoms is to know when your child isn't getting enough air into the lungs. You can measure the amount of air your child can breathe in and out with the use of a simple device called a peak flow meter so that you can recognize if the airway is narrowing. The peak flow meter measures the amount of air flow in the airways or breathing tubes. The peak flow rate is the rate of air flow in the breathing tubes when a person inhales fully and blows the air out as quickly as possible. For the test to be useful, the person must be able to repeat the same flow rate at least three times on the same peak flow meter (there are many different kinds). Peak flow rates decrease when your child's asthma is getting worse or is out of control. Peak flow rates increase when the asthma treatment is working and the airways are opening up. The use of peak flow rate measurements can help you to recognize when your child's airway is narrowing, so asthma treatment can be started early. Peak flow rates also will help you identify some of the "triggers" for your child's asthma, so they can be avoided.
How can you tell if your child's asthma is getting worse?
* Asthma symptoms such as cough, wheeze, chest tightness, shortness of breath occur more frequently and/or get worse
* Large decreases in your child's peak flow rate occur
* Asthma medications do not seem to help your child's cough or breathing problem
* You frequently have to go to the doctor or ER for treatment of acute asthma
* Your child is admitted to the hospital for asthma treatment
* Your child is admitted to a hospital intensive care unit for treatment
* Large changes in peak flow rate measurements occur (more than 20% change between morning & evening
* Your child's asthma symptoms increase; symptoms occur more often at night & awaken the child from sleep
* Your child's asthma attacks last longer and do not easily improve with treatment
* Special oral anti-inflammatory medications such as steroids are needed more often to control the asthma
* Your child's asthma attacks become quite severe
* Your child has panic attacks with severe confusion and anxiety with the asthma attacks
It is important to work with your pediatrician to develop a plan of action that is specific to your child:
* How to prevent or reduce asthma symptoms
* How to recognize asthma symptoms, especially symptoms of worsening asthma
* How to recognize what triggers your child's asthma so you can reduce asthma attacks
* What treatment should be administered first and what to do if asthma becomes worse
* What to do in an emergency
Prevention and early treatment may help reduce the number of days your child misses school or is hospitalized.
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Most People Don't Correctly Use Their Inhalers
According to a study published in the Annals of Allergy,
Asthma and Immunology earlier this year, 93 percent of asthma patients had
flaws in their inhaler technique. Only
7 percent got it all right. The most common misstep was failing to exhale
completely before inhaling the medication.
The study reported on 44 pediatric and adult asthma
patients from an allergy practice in Galveston, Texas. More than half the
patients did not fully breathe out before inhaling their asthma medication.
Other flaws included inhaling too fast through the spacer device, and not
shaking aerosol inhalers before the second puff (it’s important to shake most
aerosol inhalers several times before each puff).
Spacers are long plastic tubes used as brief holding
chambers for aerosolized asthma medication. They have a mouthpiece at one end,
and a wider opening at the other, for placement of the mouthpiece of the
inhaler. The spacer allows for greater separation (spacing) of the lips from
the opening of the inhaler resulting in the inhalation of smaller particles of
the medication. When using a spacer, more medication gets to the lung, with
less of it landing on the mouth and tongue or bouncing out of the mouth.
Although many asthma patients in the study were using
spacers, they ignored the harmonica like sound, emitted when inhaling too fast.
Many people, with or without spacers, inhale much too fast. A slow, steady inhalation is important to draw
the medication into the tiny airways deep inside the lungs.
Three components of success in controlling asthma:
1) Getting the
right prescribed inhaler
2) Using
controller medication regularly
3) Having good
inhaler technique
The second and third components present the greatest
challenge in asthma management.
Routine office visits will give your doctor an
opportunity to fine-tune the asthma management plan.
Unfortunately, you can have the best asthma medication
prescribed, and perfect timing of daily doses, but if your technique has flaws,
you may be getting very little of the medication to the lung. Furthermore, your
asthma care provider may be inclined to change your controller to a higher
potency medication, thinking the current one has failed you, which can result
in greater expense and increased risks of side effects.
Here are some tips on how to improve your inhaler
technique:
1) Ask your
doctor or nurse to critique your inhaler technique each time you have an office
visit.
2) Ask for a
spacer if you continue to have flaws in inhaler technique.
3) Have a
relative or friend videotape your inhaler technique and try to identify your
own flaws.
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