Acute Asthma Flare-up in Children: Causes, Symptoms, and Treatment

Introduction

Hello Parents, I am Dr. Ganesh Badge, Pediatric Intensivist and Consultant at Momstory by Sahyadri Hospital, Hadapsar, Mom Story. Today, I will talk to you about the acute flare-up of asthma and what to do in such situations.

Asthma is a chronic disease affecting the airways, making it difficult to breathe. It affects people of all age groups, including children. The primary issue in asthma is airway inflammation, leading to the narrowing of the airway’s diameter, which is known as bronchoconstriction. As a result, symptoms like recurrent coughing, wheezing, and chest tightness occur.

What Triggers an Acute Asthma Flare-up?

An acute worsening of asthma symptoms, also known as a flare-up, is often triggered by factors like pollen, dust mites, changes in the environment, and most commonly, viral infections.

Symptoms During a Flare-up

When a flare-up occurs, the child may not respond to ongoing treatment, resulting in difficulty eating, speaking, and in some cases, lethargy or dehydration. Immediate treatment is crucial at this stage.

Asthma Treatment Options

There are two types of asthma medications:

1. Controller Medications
2. Reliever Medications

For reliever medications, we usually advise the use of an inhaler with a spacer and a mask for children below six years of age, and only a spacer for older children. Nebulization is not recommended for home use, as it should always be administered with oxygen.

Here’s how to correctly use the inhaler with a spacer:

1. Always shake the inhaler well to mix the medicine.
2. If the inhaler has not been used for a long time, prime it by spraying at least four times.
3. Attach the inhaler to the spacer, place the mask on the child’s mouth, and press the inhaler.
4. Ask the child to exhale first, then press the inhaler and instruct them to hold their breath or breathe normally for 6 to 10 breaths.

If the child is too small, hold them on your lap, secure their neck, and gently place the mask over their nose and mouth. Press the inhaler and allow the child to breathe normally for 30 seconds to ensure the medicine is delivered properly.

Using an inhaler with a spacer ensures better drug delivery and is safer than a nebulizer.

When to Visit the Hospital

If the child does not respond to the treatment, it is essential to visit the nearest hospital for emergency care. Based on the child’s weight, we may prescribe steroids in tablet or liquid form.

How to Prevent Asthma Flare-ups

To prevent flare-ups, it is important to continue the controller medication as advised without reducing the dosage or stopping it without consulting a doctor. Additionally, using the correct inhalation technique and avoiding known triggers like allergens are crucial.