Pediatric Asthma Guidelines for Treatment and Management

Recognizing Asthma Signs and Symptoms

Parents are strongly encouraged to familiarize themselves with the signs and symptoms associated with asthma. Some children only have one sign or symptom while others experience many. Children often experience heightened asthmatic symptoms due to their narrow airway structures.

Typical signs and symptoms include:

• Recurrent and persistent cough, day and/or night
• Breathing difficulties - shortness of breath, in- and exhaling quickly
• Wheezing upon exhalation
• Chest pain or tightness
• Fatigue
• Viral infection-induced cough and/or wheezing[2,3]

Emergent care is required for children displaying any of the following symptoms:

• Cyanosis
• Severe breathing difficulties - using abdominal muscles, inward pulling of chest and sides, or nostril widening to breathe
• Increased pulse
• Sweating
• Confusion[4,5]

Pediatric Asthma Guidelines: Asthma Treatment Plan

The goal of asthma management is to minimize and control symptoms, flare-ups, and the need for medicinal intervention.

Asthma Medication and Asthma Inhalers

Both preventative, or long-term, and quick relief, or rescue, treatments are often used to treat asthma. Long-term medications are taken daily for symptom prevention. One or more of these medications may be prescribed and include both oral and inhalation treatments. Such preventative pharmaceuticals include inhaled corticosteroids, leukotriene modifiers/inhibitors, theophylline or aminophylline, and long-acting combination inhalers.[6,7]

For symptoms produced by an asthma attack, immediate treatment is required via short-acting inhalers or corticosteroids.

Asthma Triggers

Certain indoor triggers may activate asthma symptoms and attacks, including cigarette smoke, mold, cockroach feces, dust mites, detergents, cleaning products and pets. Eliminating these will aid in promoting a healthy environment and reducing health complications.

• Eradicate any secondhand smoke within homes and cars.
• Remediate any mold in the home immediately and professionally.
• Reduce the risk of a cockroach infestation by placing food in containers and dumping trash out regularly into a tightly closed trash can. Keep the kitchen clean and free of food on the floors and counters. Do not let dirty dishes sit in the sink for prolonged periods.
• Cover the child’s mattress and box spring with an allergy proof casing. If the child’s room has carpeting, use a vacuum with a HEPA filter to keep allergens within the unit. Wash clothing and linens in an unscented/hypoallergenic detergent and use unscented cleaning products in the home.
• Animal dander can trigger asthma symptoms. Pets already residing in the home should be kept away from the child’s bedroom so that he or she may have a dander-free room and have a place to rest and breathe easily.

Employing the Use of a Peak Flow Meter

The peak flow meter produces measurements indicative of lung function, along with the ability of predicting an attack, right from home. With advanced warning, adults can take precautions by administering medication at the proper time or seeking medical care. A child with a measurement below 50% may endure a severe attack, while a value measuring 50-85% suggests a moderate attack.[8]

Disclaimer

The above information is for educational purposes. Children experiencing any or all of the above symptoms should undergo an evaluation of a licensed health care provider to rule out all possible etiologies.

References

MedlinePlus. “Asthmatic-pediatric”, https://www.nlm.nih.gov/medlineplus/ency/article/000990.htm [1-2,5-7]

Mayo Clinic. “Childhood asthma”, https://www.mayoclinic.com/health/asthma-in-children/AS00034 [3-4,7]