DESCRIPTIONAsthma is a chronic disorder with recurrent attacks of wheezing and shortness of breath. The lungs, bronchi, and bronchioles are involved. Asthma can affect both sexes and all ages except newborn infants. It affects more boys than girls.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Emergency-room care and hospitalization for severe attacks.
Psychotherapy or counseling, if asthma is stress-related.
SIGNS & SYMPTOMSGeneral symptoms: chest tightness and shortness of breath; wheezing upon breathing out; coughing, especially at night, with little sputum; rapid, shallow breathing that is easier with sitting up; breathing difficulty--neck muscles tighten; enlarged chest.
Severe late symptoms. This is an emergency situation. Get the child to the hospital or treat with an emergency kit at home: bluish skin; exhaustion; grunting respiration; inability to speak; mental changes, including restlessness or confusion.
Spasm of air passages (bronchi and bronchioles), followed by swelling of the passages and thickening of lung secretions (sputum). This decreases or closes off air to the lungs. These changes are caused by allergens, such as pollen, dust, animal dander, molds, and some foods; lung infections, such as bronchitis; air irritants, such as smoke and odors; exercise; stress.
Other allergic conditions, such as eczema or hay fever; family history of asthma or allergies; exposure to air pollutants; smoking; use of some drugs, such as aspirin.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should avoid known allergens and air pollutants.
Have the child take prescribed preventive medicines regularly--don't let him omit them when he feels well.
See Appendix 19 for suggestions to reduce stress.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies and pulmonary-function test.
POSSIBLE COMPLICATIONSRespiratory failure; pneumothorax (See Glossary); lung infection; COPD (See Glossary) from recurrent attacks.
Symptoms can be controlled with treatment and strict adherence to preventive measures. Children often outgrow asthma. Without treatment, severe attacks can be fatal.
Eliminate allergens and irritants at home and at work, if possible.
Keep regular medications with the child at all times. Ask your doctor about having emergency drugs available.
Have the child sit upright during attacks.
Encourage the child to practice deep breathing each morning to loosen accumulated lung secretions.
MEDICATIONExpectorants to loosen sputum.
Bronchodilators to open air passages.
Intravenous cortisone drugs (emergencies only) to decrease the body's allergic response.
Cortisone drugs by nebulizer (See Glossary), which have fewer adverse reactions than oral forms.
Cromolyn sodium by nebulizer. This is a preventive drug.
Your doctor may prescribe:
Encourage your child to stay active but avoid sudden bursts of exercise. If an attack follows heavy exercise, the child should sit and rest and sip warm water.
DIET & FLUIDS
No special diet, but avoid serving foods to which your child is sensitive. When the child is old enough, give instructions regarding which foods to avoid when away from home. The child should drink at least 6 to 8 8-ounce glasses of liquid daily to keep secretions loose.
OK TO GO TO SCHOOL?When signs of infection have decreased, appetite returns, and alertness, strength, and feeling of well-being will allow. Make every attempt to keep your child in the mainstream of peer activities. Over-protection can be harmful.
CALL YOUR DOCTOR IF
Your child has symptoms of asthma.
Your child has an asthma attack that doesn't respond to treatment. This is an emergency!
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.