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    Asthma, Pediatric

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    Oct.10.2022
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    Asthma, Pediatric

    Asthma, Pediatric

    Outline of a person's upper body showing the lungs, with close-ups of two airways, one normal and one narrow.

    Asthma is a long-term (chronic) condition that causes recurrent episodes in which your child's lower airways (bronchi) in the lungs become tight and narrow. The narrowing is caused by inflammation and tightening of the smooth muscle around the lower airways.

    Asthma episodes, also called asthma attacks or asthma flares, may cause coughing, making high-pitched whistling sounds when your child breathes, most often when your child breathes out (wheezing), shortness of breath, and chest pain. The airways may produce extra mucus caused by the inflammation and irritation. During an attack, it can be difficult to breathe. Asthma attacks can range from minor to life-threatening.

    Asthma cannot be cured, but medicines and lifestyle changes can help to control your child's asthma symptoms. It is important to keep your child's asthma well controlled so the condition does not interfere with your child's daily life.

    What are the causes?

    This condition is believed to be caused by inherited (genetic) and environmental factors, but its exact cause is not known.

    What can trigger an asthma attack:

    Many things can bring on an asthma attack or make symptoms worse (triggers). These triggers are different for every person. Common triggers include:
    • Household allergens and irritants like mold, dust, pet dander, cockroaches, pollen, air pollution, and chemical odors.
    • Cigarette smoke.
    • Weather changes and cold air.
    • Stress and strong emotional responses such as crying or laughing hard.
    • Infections and inflammatory conditions such as the flu, a cold, pneumonia, or inflammation of the nasal membranes (rhinitis).
    • Gastroesophageal reflux disease (GERD).
    • Exercise or strenuous activity.

    What are the signs or symptoms?

    Symptoms can occur right after exposure to an asthma trigger or hours later, and vary by person. Common signs and symptoms include:
    • Wheezing.
    • Trouble breathing (shortness of breath).
    • Nighttime or early morning coughing.
    • Frequent or severe coughing with a common cold.
    • Chest tightness.
    • Tiredness (fatigue) with little activity or play.
    • Difficulty talking in complete sentences during an asthma flare.
    • Poor exercise tolerance.

    How is this diagnosed?

    This condition may be diagnosed based on:
    • A physical exam and medical history.
    • Testing, which may include:
      • Lung function studies to evaluate the flow of air in your child's lungs.
      • Allergy tests.
      • Imaging, such as X-rays.

    How is this treated?

    Two respiratory inhalers.

    There is no cure, but symptoms can be controlled with proper treatment. Treatment usually includes:
    • Identifying and avoiding your child's asthma triggers.
    • Inhaled medicines. Two types are commonly used to treat asthma, depending on severity:
      • Controller medicines. These help prevent asthma symptoms from occurring. They are taken every day.
      • Fast-acting reliever or rescue medicines. These quickly relieve your child's asthma symptoms. They are used as needed and provide short-term relief.
    • Using other medicines, such as:
      • Allergy medicines, such as antihistamines, if your asthma attacks are triggered by allergens.
      • Immune medicines (immunomodulators). These are medicines that help control the body's defense (immune) system.
    • Using supplemental oxygen. This is only needed during a severe episode.

    Your child's health care provider will help you create a written plan for managing and treating your child's asthma flares (asthma action plan). This plan includes:
    • A list of your child's asthma triggers and how to avoid them.
    • Information on when your child should take his or her medicines and when to change his or her dosage.
    • Instructions about using a device called a peak flow meter. A peak flow meter measures how well your child's lungs are working and the severity of your child's asthma. It helps you monitor his or her condition.

    Follow these instructions at home:

    • Give over-the-counter and prescription medicines only as told by your child's health care provider.
    • Make sure to stay up to date on your child's vaccinations as told by his or her health care provider. This may include vaccines for the flu and pneumonia.
    • Use a peak flow meter as told by your child's health care provider. Record and keep track of your child's peak flow readings.
    • Once you know what your child's asthma triggers are, take actions to avoid them.
    • Understand and use the asthma action plan to address an asthma flare. Make sure that all people providing care for your child:
      • Have a copy of the asthma action plan.
      • Understand what to do during an asthma flare.
      • Have access to any needed medicines, if this applies.
    • Do not smoke or let anyone smoke around your child or in your home.
    • Keep all follow-up visits. This is important.

    Contact a health care provider if:

    • Your child has wheezing, shortness of breath, or a cough that is not responding to medicines.
    • Your child's medicines are causing side effects, such as a rash, itching, swelling, or trouble breathing.
    • Your child needs reliever medicines more often than 2–3 times per week.
    • Your child's peak flow measurement is at 50–79% of his or her personal best (yellow zone) after following his or her asthma action plan for 1 hour.
    • Your child has a fever with shortness of breath.

    Get help right away if:

    • Your child's peak flow is less than 50% of his or her personal best (red zone).
    • Your child is getting worse and does not respond to treatment during an asthma flare.
    • Your child is short of breath at rest or when doing very little physical activity.
    • Your child has difficulty eating, drinking, or talking.
    • Your child has chest pain.
    • Your child's lips or fingernails look bluish.
    • Your child is light-headed or dizzy, or he or she faints.
    • Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.

    These symptoms may be an emergency. Do not wait to see if the symptoms will go away. Get help right away. Call 911.

    Summary

    • Asthma is a long-term (chronic) condition that causes recurrent episodes in which the airways become tight and narrow. Asthma episodes, also called asthma attacks or asthma flares, can cause coughing, wheezing, shortness of breath, and chest pain.
    • Asthma cannot be cured, but medicines and lifestyle changes can help keep it well controlled and prevent asthma flares.
    • Make sure you understand how to help avoid triggers and how and when your child should use medicines.
    • Asthma flares can range from minor to life threatening. Get help right away if your child has an asthma flare and does not respond to treatment with the usual rescue medicines.

    This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.

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