Asthma is the most common chronic disease among school-aged children. It affects about 7 million in the United States alone. It is characterized by an inflammatory state that causes the airways to narrow, hindering breathing. Afflicted sufferers suffer from periodic "attacks" followed by worsening of symptoms. If not treated quickly, an asthma crisis can progress and lead to serious injury or even death. Therefore, it is essential to recognize it in infant subjects as quickly and accurately as possible.
Steps
Part 1 of 4: Listen to the Child
Step 1. Pay attention to any mention of breathing problems
A slightly older child or one who has already suffered from asthma attacks is able to sense a seizure in the bud. If he tells you bluntly that he "can't breathe" or that he's having trouble breathing, don't ignore it! During the milder stages, it may wheeze, while in the more severe it is not certain that this symptom is present.
Step 2. Take complaints about chest pain seriously
During an asthma attack, you may also feel chest pain or a feeling of tension in this area. Chest pain is common during asthma attacks because air gets trapped in the blocked airways and chest pressure can increase. In these cases, you may also notice a decrease in breathing noises due to the narrowing of the airways.
Step 3. Be aware of the child's limitations
If he is very young or has never suffered from asthma, he may not be able to explain a difficulty in breathing or chest pain. Rather, he may panic and vaguely describe the symptoms: "I'm feeling weird" or "I'm not well". Watch children with asthma to understand what are the obvious signs of a seizure, such as wheezing or wheezing. Don't assume it's not an asthma attack just because it doesn't communicate breathing problems or chest pain.
Step 4. Measure your respiratory rate
Infants and very young children (i.e. up to 6 years of age) have a faster metabolism which, in turn, increases the respiratory rate. Because they can't describe their symptoms correctly at this age, watch how they breathe. Any suspicion of an alteration is sufficient to warrant looking for other symptoms. The number of breaths per minute can vary greatly in smaller patients, but typically the values are:
- Newborn (0 to 1 year) 30-60 breaths per minute;
- Young children (1 to 3 years old) 24-40 breaths per minute;
- Preschoolers (3 to 6 years old) 22-34 breaths per minute.
Step 5. Take environmental factors into account
Most children with asthma show the first signs of this condition by age 5, when they begin to react poorly to triggers. The latter can even cause an exacerbation of symptoms. They vary from subject to subject, so consider anything that triggers an attack, especially when you suspect it's coming. It is possible to eliminate some triggers (such as dust mites and animal hair), but others (such as air pollution) must be kept under control as best as possible. The most common ones include:
- Animal hair: To get rid of it, you can use a vacuum cleaner or a damp cloth.
- Dust mites: To protect your child, use mattresses and pillow cases, wash the sheets often, do not put soft toys in their bedroom, and avoid feather-filled pillows and blankets.
- Cockroaches: together with their droppings they constitute a trigger. To keep them away from your home, don't leave food and water lying around. Sweep the floor immediately to remove all crumbs and fallen debris and clean the house regularly. Consult an exterminator for pest advice.
- Mold: This is caused by humidity, so use a hygrometer to find out how humid the home is. Use a dehumidifier to prevent this and prevent mold from forming.
- Smoking: Any kind - from that produced by burning tobacco to smoking wood - can trigger an asthma attack. Even if you smoke outside on the balcony, it could remain on your clothes and in your hair putting your child at risk.
- Certain foods: Eggs, milk, peanuts, soy products, wheat, fish, seafood, salads, and fresh fruit can trigger asthma attacks in allergic children.
- Air pollution or abrupt changes in weather.
Step 6. Check his behavior
Eliminating all triggers may not be enough. If a child is highly emotional (perhaps sad, happy, or easily frightened), he or she is at greater risk for asthma attacks. Likewise, excessive physical exertion could leave him breathless and cause him to breathe more deeply, triggering a crisis.
Step 7. Treat airway infections
appropriately. Any viral or bacterial infection affecting the upper or lower respiratory tract can trigger an asthma attack. Take your child to the pediatrician if he shows signs of an airway infection. He may need medication to manage symptoms or eradicate it quickly.
Keep in mind that antibiotics only treat bacterial infections. Those of a viral nature must be treated by monitoring their evolution rather than adopting a drastic approach aimed at eradicating them
Part 2 of 4: Assessing the Baby's Breathing
Step 1. Notice if you are breathing fast
In adults, the normal respiratory rate is no more than 20 breaths per minute. In children, however, it can be faster even at rest, depending on age. It is best to see if there are any signs of abnormal breathing.
- Children between the ages of 6 and 12 should take around 18-30 breaths per minute.
- Babies and teens between the ages of 12 and 18 should take about 12-20 breaths per minute.
Step 2. Notice if you are trying to breathe
A baby who breathes normally uses the diaphragm primarily. However, if you have an asthma attack, it may start working other muscles in an attempt to bring in more air. Look for signs that your neck, chest, and stomach muscles are fatigued.
A child who has difficulty breathing leans forward, placing his arms on his knees or on the table. If you notice your child in this position, he may have an asthma attack
Step 3. Listen for wheezing
Babies with asthma often emit a thin, vibrating whistle when they breathe. It usually happens as they exhale, because air is forced out through the narrowing airways.
You may feel wheezing in both the inspiratory and expiratory phases. However, keep in mind that during milder asthma attacks or more severe early attacks you can only notice this when the baby exhales
Step 4. Pay attention to coughs
Asthma is the most common cause of persistent cough in children. Coughing increases the pressure in the blocked airways forcing them to open and temporarily improving the passage of air. So, although it helps the baby to breathe, it is a symptom of a more serious problem because it occurs when the body tries to excrete the substances responsible for the attack.
- Coughing can also indicate a respiratory infection, on which asthma depends.
- Night cough is a common symptom of mild and moderate forms of persistent asthma in children. However, if the person coughs repeatedly for a long time, it could be a seizure.
Step 5. Look for retraction marks
Retractions are visible contractions that occur along the intercostal spaces or in the collarbone area during breathing. They occur when the muscles find it difficult to enter air, which cannot spread fast enough to widen the chest due to the obstruction of the airways.
If the intercostal retractions seem light, take the baby to the doctor as soon as you can. If they are moderate or severe, call the emergency room
Step 6. Check if your nostrils widen
When a baby has difficulty breathing, they tend to widen their nostrils. It is a very useful sign in detecting an asthma attack in infants and very young children who are unlikely to be able to communicate their symptoms or lean forward as older children do.
Step 7. Pay attention to the "silent chest"
If he seems distressed, but you can't hear wheezing, he may be suffering from a so-called "silent chest". It occurs in severe cases, when the airways become so obstructed that the passage of air is not even enough to produce a hiss. In case of "silent chest", you need to seek medical attention urgently. The baby may be so tired from the effort it takes to breathe that they cannot excrete carbon dioxide or absorb enough oxygen.
If he is unable to utter a sentence completely, it means he is not getting enough oxygen and therefore needs medical attention
Step 8. Use a peak expiratory flow meter to determine the severity of the asthma crisis
It is a simple device used to measure the "peak expiratory flow" (PEF or PEFR). Use it every day to figure out your child's normal PEFR. If the readings are abnormal, they will serve as the first warning sign to predict an attack. Normal ones vary according to the age and height of the child. Ask your doctor for more information on the three measurement zones and what to do if the peak flow reading falls within the red or yellow zone. In principle:
- Readings between 80 and 100% of the usual peak flow are in the "green zone" (very low risk of attack).
- Readings between 50 and 80% of the usual peak flow are in the "yellow zone" (moderate risk; continue to measure and administer whatever treatment your doctor has prescribed for this zone).
- Readings below 50% of the usual peak flow indicate a very high risk of attack. Give your child an immediate-release drug and take him to the doctor.
Part 3 of 4: Assessing the Baby's Appearance
Step 1. Evaluate the general appearance
Children with asthma often find it so hard to breathe that you can't help but notice. If you have the feeling that your child is having enormous difficulty breathing or that there is "something wrong", trust your instincts. Give him his inhaler or give him the immediate release medication prescribed by the doctor and, if you can, have him examined.
Step 2. Check if your skin is pale and clammy
When a child has an asthma attack, he struggles to breathe. As a result, the skin may appear clammy or sweaty. However, instead of turning red as it does when exercising, it turns pale during an asthma attack. Blood turns red only in the presence of oxygen, so if your body is lacking it, you won't see the red flushes typical of proper blood circulation.
Step 3. Notice if the skin turns cyanotic
If you notice bluish tinges on the body or on the lips and nails, it means that the asthma attack is very serious: the child has a severe lack of oxygen and needs immediate medical attention.
Part 4 of 4: Help the Child
Step 1. Give him asthma medications
If you have already suffered from asthma attacks, your doctor will probably have prescribed an inhaled medication. Give it to him immediately in case of an attack. While it is not difficult to use an inhaler, there is always a risk of misusing it and diminishing its effectiveness. For a correct use:
- Remove the cap and shake it vigorously.
- Prepare it if necessary. If it is new or has not been used for a long time, spray some medicine into the air before using it.
- Let the baby exhale completely, then invite him to inhale as you dispense the medication.
- Tell him to continue inhaling as slowly and deeply as possible for 10 seconds.
- In the case of a pediatric inhaler, always use a spacer to help get the drug into the lungs rather than the back of the throat. Ask your doctor how to use it correctly.
Step 2. Read the instructions before giving a second dose
They will tell you if you need to wait before delivering another dose. If you are using a β2-agonist, such as salbutamol, wait a full minute before giving it again. If the inhaler does not contain a β2-agonist, the waiting time may be shorter.
Step 3. See if the drug is effective
You should see results within minutes of dispensing. If not, you can decide whether to give it again. Follow the dosage instructions in the package or follow your doctor's advice (for example, immediately dispense another dose). If symptoms do not improve, seek medical attention.
Step 4. Call your pediatrician if you notice mild but persistent symptoms
They may include coughing, wheezing, or a slight increase in breathing effort. Contact your pediatrician if the attack is mild, but symptoms do not improve despite taking the drug. He may advise you to take the child to his office or give you more specific instructions.
Step 5. Go to the emergency room if severe symptoms don't go away
The "silent chest" and cyanosis of the lips and nails indicate that the baby is lacking in oxygen. In these cases, immediate care is needed to ward off the risk of brain damage or even death.
- If you have asthma medication available, you can give it to him along the way to the emergency room. However, don't delay taking your baby to the hospital.
- If you delay seeking emergency treatment during a severe asthma crisis, permanent brain damage and even death can result.
- Call 911 right away if your child becomes cyanotic despite taking the bronchodilator or if cyanosis spreads beyond the lips and nails.
- Call 911 immediately if you lose consciousness or have difficulty waking up.
Step 6. Call 911 if the asthma attack is triggered by an allergic reaction
If the crisis was caused by a food allergy, insect bite, or medication, call 911. These reactions can progress rapidly and promote narrowing of the airways.
Step 7. Know what awaits you in the ER
Your doctor will detect the signs and symptoms of asthma. Once the baby arrives in the emergency room, he will be given oxygen as needed and given more medication. If the asthma attack is severe, medical staff may give you an intravenous corticosteroid. Typically, patients get better once they are hospitalized, so you will be able to get your child home soon. However, if he doesn't improve within a few hours, they could keep him in the hospital overnight.
