Children's Health

Treatment of Asthma

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Acute severe asthmatic episode (status asthmaticus) often requires medical attention. It is treated by providing oxygen or even mechanical ventilation in severe cases. Repeat or continuous doses from an inhaler (beta-2 agonist) reverse airway obstruction. If the asthma isn't corrected using the inhaled bronchodilator, injectable epinephrine and/or systemic corticosteroids are given to reduce inflammation.

Fortunately, for most children, asthma can be well controlled. For many families, the learning process is the hardest part of controlling asthma. A child might have flares (asthma attacks) while learning to control asthma, but don't be surprised or discouraged. Asthma control can take a little time and energy to master, but it's worth the effort!

How long it takes to get asthma under control depends on the child's age, the severity of symptoms, how frequently flares occur, and how willing and able the family is to follow a doctor's prescribed treatment plan. Every child with asthma needs a doctor-prescribed individualized asthma management plan to control symptoms and flares. This plan usually has 5 parts.

The Five Parts to an Asthma Treatment Plan

Step 1 - Identifying and controlling asthma triggers

Children with asthma have different sets of triggers. Triggers are the factors that irritate the airways and cause asthma symptoms. Triggers can change seasonally and as a child grows older. Some common triggers are allergens, viral infections, irritants, exercise, breathing cold air, and weather changes.

Identifying triggers and symptoms can take time. Keep a record of when symptoms occur and how long they last. Once patterns are discovered, some of the triggers can be avoided through environmental control measures, which are steps to reduce exposure to a child's allergy triggers. Talk with your doctor about starting with environmental control measures that will limit those allergens and irritants causing immediate problems for a child. Remember that allergies develop over time with continued exposure to allergens, so a child's asthma triggers may change over time.

Others who provide care for your child, such as babysitters, daycare providers, or teachers must be informed and knowledgeable regarding your child's asthma treatment plan. Many schools have initiated programs for their staff to be educated about asthma and recognize severe asthma symptoms.

The following are suggested environmental control measures for different allergens and irritants:

• Indoor controls
  • To control dust mites:
    • Use only polyester-filled pillows and comforters (never feather or down). Use mite-proof covers (available at allergy supply stores) over pillows and mattresses. Keep covers clean by vacuuming or wiping them down once a week.
    • Wash your child's sheets and blankets once a week in very hot water (130 F or higher) to kill dust mites.
    • Keep upholstered furniture, window mini-blinds, and carpeting out of a child's bedroom and playroom because they can collect dust and dust mites (especially carpets). Use washable throw rugs and curtains and wash them in hot water weekly. Vinyl window shades that can be wiped down can also be used.
    • Dust and vacuum weekly. If possible, use a vacuum specially designed to collect and trap dust mites (with a HEPA filter).
    • Reduce the number of dust-collecting house plants, books, knickknacks, and nonwashable stuffed animals in your home.
    • Avoid humidifiers when possible because moist air promotes dust mite infestation.
  • To control pollens and molds:
    • Avoid humidifiers because humidity promotes mold growth. If you must use a humidifier, keep it very clean to prevent mold from growing in the machine.
    • Ventilate bathrooms, basements, and other damp places where mold can grow. Consider keeping a light on in closets and using a dehumidifier in basements to remove air moisture.
    • Use air conditioning because it removes excess air moisture, filters out pollens from the outside, and provides air circulation throughout your home. Filters should be changed once a month.
    • Avoid wallpaper and carpets in bathrooms because mold can grow under them.
    • Use bleach to kill mold in bathrooms.
    • Keep windows and doors shut during pollen season.
  • To control irritants:
    • Do not smoke (or allow others to smoke) at home, even when a child is not present.
    • Do not burn wood fires in fireplaces or wood stoves.
    • Avoid strong odors from paint, perfume, hair spray, disinfectants, chemical cleaners, air fresheners, and glues.
  • To control animal dander:
    • If your child is allergic to a pet, you may have to consider finding a new home for the animal or keeping the pet outside at all times.
    • It may (but does not always) help to wash the animal at least once a week to remove excess dander and collected pollens.
    • Never allow the pet into the allergic child's bedroom.
    • If you don't already own a pet and a child has asthma, don't acquire one. Even if a child isn't allergic to the animal now, he or she can become allergic with continued exposure.
• Outdoor controls
  • When mold or pollen counts are high, give your child medications recommended by your doctor (usually an antihistamine) before going outdoors.
  • After playing outdoors, the child should bathe and change clothes.
  • Drive with the car windows shut and air conditioning on during mold and pollen seasons.
  • Don't let a child mow the grass or rake leaves.