What Is an Asthma Attack or Flare Up
An asthma attack is a sudden worsening of your asthma symptoms caused by narrowing of your airways or bronchoconstriction as a result of inflammation, swelling, and mucus. Both you and your child need to:
- Understand The Asthma Care Plan
- Know Your Child's Symptoms
- Know Your Child's Peak Flow
- Know Your Child's Medications
- Recognize Early Warning Signs
- Identify Indications For Emergency Care
Understand Your Asthma Care Plan:
For anyone who has asthma, an asthma action plan is essential. This plan is your guide to determining how well your child’s asthma is controlled and what actions need to be taken when asthma worsens. With your input, your doctor will develop your child's asthma care plan. Most plans have 3 components:
- Stage of severity- identified by the peak expiratory flow rate
- A list of symptoms to watch for
- Specific actions to take based on peak flow or symptoms
Make sure you understand the plan and do not be afraid to ask questions. Make sure any other caregivers and his/ her school understand the asthma care plan as well.
Know Your Child's Symptoms:
Everyone with asthma is different. Some people will have frequent attacks while others may go a long period between attacks. You need to monitor your child’s asthma symptoms like coughing, wheezing, shortness of breath. The action plan that you and your child's healthcare provider have developed will list how to treat asthma symptoms.
Know Your Child's Peak Flow:
A peak flow meter is the key to determining how your child’s asthma is doing. It tells you how well they are breathing and its use is a key part of the asthma action plan.
If peak flow numbers are declining, your child’s asthma is getting worse. You need to give medications based on the instructions in the asthma care plan to stop the symptoms from getting more severe.
Know Your Child's Medications:
Understanding the purpose of each medications in the treatment of asthma is very important because some medications are designed for the acute relief of asthma and some for the long term control of asthma. Taking a long-term beta agonist control medication during an acute asthma attack can actually lead to worsening of asthma.
The asthma care plan will outline which specific medications to take depending on peak flow and other symptoms.
Recognize early warning signs:
As a parent of a child with asthma it is very important that you recognize and treat the early warning signs of an asthma attack. Appropriate management early on may prevent a trip to the ER, an admission to the hospital or worse. Generally, early warning signs include:- A drop in peak expiratory flow rate
- Increased cough
- Wheezing
- Chest tightness
- Some difficulty performing normal daily activities
- Individual factors you notice over time that indicate worsening asthma
Your child will likely be in the ‘yellow zone’ of the asthma care plan when developing these symptoms. Based on your asthma care plan, follow the instructions about taking extra doses of quick-relief medications and initiating other treatments like a course of oral corticosteroids. The asthma care plan will have instructions regarding how to proceed and when to call your doctor.
Most of the time when symptoms are identified and treated early, you will notice a prompt improvement in both peak flow and symptoms. However, you need to be prepared if your symptoms don’t improve.
Make sure you discuss your asthma care plan with your health care provider. If your child is frequently needing to step up asthma treatment because of symptoms or worsening peak flows, this is a sign of poor control and adjustments to the plan may be needed.
Identify Indications for emergency care:
One of the most important skills as a parent of a child with asthma is to know when you need no longer treat asthma at home, call your doctor, or just head to the emergency department. All of the following symptoms are indications that your child needs to seek a healthcare provider for emergency care immediately:- Wheezing that occurs while breathing both in and out
- Coughing that has become continuous
- Difficulty breathing
- Tachypnea or breathing very fast
- Retractions where your skin is pulled in as you breath
- Shortness of breath
- Difficulty talking in complete sentences
- Becoming pale
- Becoming anxious
- Blue lips or fingernails called cyanosis
If your child has any of these symptoms, they are in the ‘red zone’ of the asthma care plan and you should begin following those instructions immediately, which should also include seeing a healthcare provider. Make sure that you keep your emergency numbers and details of who to contact in an emergency situation in an easily identifiable place like the refrigerator or a bulletin board near your phone. It is also a good idea to carry this information with you.
Adult recommendations do not significantly differ for handling an acute asthma flare.
When your child's asthma is under control, they should be free of asthma symptoms and able to do most of their normal activities. Prompt identification and action when asthma worsens will prevent complications and frequent visits to the emergency department.
Sources:
National Heart, Lung, and Blood Institute. Accessed: January 1, 2008. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma
Asthma. In Chest Medicine: Essentials Of Pulmonary And Critical Care Medicine. Editors: Ronald B. George, Richard W. Light, Richard A. Matthay, Michael A. Matthay. May 2005, 5th edition.
