Managing Acute Asthma Flare-Ups in Children

Introduction:

Hello Parents, I am Dr. Ganesh Badge, a Pediatric Intensivist and Consultant at Sahyadri Hospital, Hadapsar Momstory. Today, I am going to talk about acute flare-ups of asthma and how to manage them. Asthma is a chronic disease that affects the airways and is common across all age groups, including children.

What is Asthma?

Asthma is a condition where the airways become inflamed, leading to constriction, which makes it difficult to breathe. This causes symptoms like coughing, wheezing, chest tightness, and difficulty breathing. Asthma flare-ups can be triggered by various factors such as pollen, dust mites, changes in the environment, and most commonly, viral infections.

What Happens During an Acute Asthma Flare-Up?

During an acute flare-up, the symptoms of asthma become more severe. Despite starting treatment, children may not respond well, making it hard for them to eat, speak, or even drink. They may feel lethargic or dehydrated, which makes immediate treatment essential.

Types of Asthma Medications:

We use two main types of medications for asthma:

1. Controller Medications – These are used regularly to control asthma.
2. Reliever Medications – These provide immediate relief during flare-ups.

For younger children (under 6 years old), we recommend inhalers with a spacer and mask, as nebulization at home should be avoided. Nebulization should always be done under medical supervision with oxygen.

How to Use an Inhaler with a Spacer?

Here’s the correct method for using an inhaler with a spacer:

• Shake the Inhaler: Shake it well to ensure the medication is mixed properly.
• Prime the Inhaler: If the inhaler has not been used for a while, prime it by spraying at least four times.
• Attach the Spacer and Mask: Fit the spacer properly and ensure the mask is attached correctly.
• Press and Breathe: Press the inhaler and ask the child to hold their breath. If they cannot hold their breath, ask them to breathe normally 6-10 times.
• For infants or very young children, hold them on your lap, attach the mask to their face, and press the inhaler. The child should breathe normally for about 30 seconds.

Using an inhaler with a spacer is more effective and safer than nebulization at home.

What to Do if Treatment is Not Effective?

If the child does not respond to the medication, it is important to visit the nearest hospital or emergency care center immediately. In such cases, steroids may also be prescribed depending on the child’s weight, either in tablet or liquid form.

Preventing Asthma Flare-Ups:

1. Continue Controller Medications: Ensure that the prescribed dose of controller medication is taken consistently. Never reduce the dose or stop the medication without a doctor’s advice.
2. Use Proper Technique: Always use the inhaler with a spacer properly.
3. Avoid Triggers: Identify and avoid allergens or other triggers that may cause flare-ups.

Conclusion:

By following these guidelines and staying vigilant, asthma flare-ups can be managed effectively.