Asthma is an extremely common chronic condition, with one in eleven children affected. It is the most common respiratory disorder of children. There are over 25,000 emergency hospital admissions for asthma amongst children in the UK every year.
‘Every 20 minutes a child is admitted to hospital having an Asthma attack. Every day, the lives of three families are devastated by the death of a loved one to an asthma attack, and tragically two thirds of these deaths are preventable,’ – Asthma.org.uk
Asthma is a potentially life threatening condition and so it is really important that everyone in contact with the child knows the best way to quickly help quickly in an emergency.
When someone is having an Asthma attack; their airways go into spasm which causes tightness of the chest; the linings of the airways become inflamed and phlegm is produced further obstructing the airways and leading to severe difficulty in breathing.
Asthma is a common long-term condition that can cause coughing, wheezing, chest tightness and breathlessness. The severity of these symptoms varies from person to person. Asthma can be controlled in most people most of the time, although some people have more persistent problems.
Diagnosing asthma in children can be a lengthy process, particularly if the child is very young. In the meantime, doctors are likely to prescribe blue reliever inhalers (salbutamol) and other medication to try and control symptoms and manage the condition and will refer the child to a specialist.
What causes asthma?
Asthma is caused by inflammation of the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal. When you come into contact with something that irritates your lungs – known as a trigger – your airways become narrow, the muscles around them tighten, and there is an increase in the production of sticky mucus (phlegm).
How asthma is treated
While there is no cure for asthma, there are a number of treatments that can help control the condition.
Treatment is based on two important goals, which are:
- relieving symptoms
- preventing future symptoms and attacks
For most people, this will involve the occasional – or, more commonly, daily – use of medications, usually taken using an inhaler. However, identifying and avoiding possible triggers is also important. Once children have been diagnosed they should have a personal asthma action plan that includes information about the medicines they need to take, how to recognise when their symptoms are getting worse, and what steps to take when they do so. This plan should be regularly reviewed with the parents to ensure that those caring for the child are updated with any changes.
Children should have their prescribed asthma inhaler easily and quickly accessible at all times.
Learn the triggers:
There are many different triggers for Asthma attacks and many asthmatics are well aware of their trigger points, although they may not always be able to avoid them. In young children, they may be still trying to establish the cause.
Often a child may have other known allergies and sensitivities and may have been prescribed an adrenaline autoinjector (Epipen, Jext or Emerade) too.
If there is a family history of asthma, eczema or allergies there is a higher incidence that the child may develop asthma. Research has also shown that smoking during pregnancy significantly increases the risk of a child developing asthma. Similarly, children whose parents smoke are more likely to develop asthma.
Exercise can trigger attacks in some children; children should not avoid exercise because they are asthmatic, however they should always have their reliever inhaler with them.
Symptoms of an asthma attack:
- Persistent cough (when at rest)
- A wheezing sound coming from the chest (when at rest)
- Difficulty breathing (the child could be breathing fast and with effort, using all accessory muscles in the upper body)
- Nasal flaring
- Unable to talk or complete sentences. Some children will go very quiet.
- May try to tell you that their chest ‘feels tight’ (younger children may express this as tummy ache)
CALL AN AMBULANCE IMMEDIATELY AND COMMENCE THE ASTHMA ATTACK PROCEDURE WITHOUT DELAY IF THE CHILD
- Appears exhausted
- Has a blue/white tinge around lips
- Is going blue
- Has collapsed
Not everyone will get all of these symptoms.
NOTE: Encouraging someone to sit upright is generally helpful when dealing with breathing problems. Sitting the wrong way round on a chair may be a good position for them as it it a good open position for their lungs and the back of the chair will give additional support.
DO NOT take them outside for fresh air if it is cold – as cold air can make symptoms worse.
Using a spacer device has been shown to deliver medication more effectively and increases the amount of the medication reaching the airways rather than hitting the back of the throat and use of a space device can help sufferers achieve better control of their asthma.
Spacers come in a variety of shapes and sizes, but not all spacers fit all types of inhalers – use the spacer prescribed with the inhaler. Spacers for smaller children are usually fitted with a face mask. There is considerable co-ordination required to use an inhaler without a spacer and this can lead to increased stress and worsening of symptoms.
Always keep the spacer with the inhaler and have both available at all times.
How to help in an asthma attack
The following guidelines are suitable for both children and adults:
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Calm the situation and reassure the child as this can help them to control their symptoms. Panic can increase the severity of an attack. Assist them to take one to two puffs of the reliever inhaler (usually blue) – using a spacer device if available.
- Sit them down, loosen any tight clothing and encourage them to take slow, steady breaths.
- If they do not start to feel better, they should take more puffs of their reliever inhaler (up to 10 at roughly 2 minute intervals)
- If thee is no improvement after taking their inhaler as above, or if you are worried at any time, call 999/112.
- They should keep taking the reliever inhaler 2 puffs every 2 minutes, whilst waiting for the paramedics to arrive
Please note that if they have taken more than 10 puffs at a time it won’t have done them any harm. Salbutamol is a well-tested medication and the main side effects from overdosing are light headedness and a slight tremor of the hands – both of which will resolve without treatment.
After an asthma attack:
Within 48 hours of their attack, they should see their asthma nurse for an asthma review.
People often have a variety of different asthma inhalers and medication to control their asthma – if they are having an asthma attack it is the reliever inhaler that they need. Reliever inhalers are usually blue and the other inhalers are often steroid based to reduce their sensitivity to asthma inducing agents
Please visit www.firstaidforlife.org.uk, email firstname.lastname@example.org or tel 0208 675 4036 for more information about our courses and the specialist First Aid support we give to schools, nurseries and child carers. First Aid for life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made, or actions taken based on this information.