Author Archives: Jackie Aim

What if my child is admitted to hospital ?

Young girl in a hospital bed

Occasionally your child may be admitted to hospital if they are very wheezy, their oxygen levels are low or they need help with their feeding.
The nurses will make regular observations of your child’s temperature, heart rate, breathing and oxygen levels.
Your child may be given extra oxygen if their levels of oxygen are low. This can be given by a mask or small tubes called a cannula that fit just inside the nose.
Your child may be given a short course of oral steroids to reduce any inflammation or redness in their airways, usually for 3 or 5 days.
The nurses will give any inhalers that have been prescribed and monitor their effect.
As a parent you should be given instructions on how to give your child their inhalers correctly or how to supervise them while they are taking them by themselves. Medicine can only work if it is taken properly.
If you have questions about your child’s asthma or how to help them get back to normal activity such as school or exercise speak to the hospital staff.
You could ask for an individual child asthma plan and leaflets which you can take home or go through with the staff.

Check list for parents at time of discharge

Are you sure you know how to supervise your child taking their inhaler properly?
Has someone given you enough information about any new drugs your child has been given?
Are you confident in your abilities to manage a severe attack? When you should get help in the future?
Does anyone need to be informed about any changes to your child’s care, e.g. school, child minder, after school club or other family members?

What if my child has a severe attack of wheezing?

cartoon_ambulance

You may notice your child’s breathing becomes a real effort. Have a look to see if their chest, tummy or neck muscles are pulling in when they take a breath.
- Are they breathing much faster than normal?
- Are they struggling to breathe?
- Are they no better after the 4 puffs of their reliever (blue) medicine?
If so they need an emergency dose of the reliever inhaler. This can be given as 10 puffs through the spacer device following the inhaler technique.
This is an emergency dose of medicine and if you need to give it again within 4 hours or give it twice within 24 hours at home, you need to seek medical advice.
If you have any concerns about your child’s breathing call 999 for an ambulance.
When you call 999 you will need to give the operator details of your child’s name, address and date of birth. If you can tell them exactly what medication and how much you have given them this is really useful information. They can give you instructions while you are on the phone call and let you know when the ambulance or paramedic will arrive.

Important

If your child cannot talk, is gasping for breath, has colour change or if you are worried and unsure you should phone 999 for an ambulance and continue to give 1 puff of the blue inhaler every minute until help arrives.

What will I do if my child has a further wheezy episode?

Examples of asthma plans

Starting treatment early is key and may prevent the need for a hospital admission and the distress this can be for you and your child.
As soon as you see the symptoms of a cold, infection or a known trigger start using your child’s reliever (blue) inhaler 2-4 puffs every 4 hours for around 4 days when their symptoms are at their worst.
You may have been given an asthma plan for your child which will tell you what to do if they are feeling worse or if you notice they are wheezing. If you do not have an asthma plan, ask about this at your next appointment.
If they are on a preventer inhaler they should continue to use this as normal.

Important

If there is no improvement or you are worried about your child make an appointment to see their GP or nurse for review – there are out of hours GP services or A&E, day or night – no one should delay seeking medical advice if you are worried.

Self management

Teenage asthma plan (NHS Scotland 2015) [.pdf, 41 KB]
Child asthma plan (NHS Scotland 2015) [.pdf, 40 KB]

How will I give my child their medicine?

There are specific techniques for using inhalers with or without spacer devices depending on the age of your child and the prescribed inhaler they are given. It is very important to follow the specific instructions about how to use the inhalers as given by the doctor, nurse or pharmacist. It is useful to have a health professional check your child’s inhaler technique regularly.

Techniques for using inhalers

You should know the difference between a preventer and a reliever inhaler and when to use each one.
Sometimes your child will be given medicine as a tablet. Check if these tablets are suitable to be crushed or not.
Sometimes when you give medicine you should get your child to wipe their mouth, brush their teeth or give a drink. You can get advice about if this is necessary from your healthcare professional.
Check the time of day the inhaler or medicine should be given and get in to a routine which suits you and your child. For example put inhalers next to their toothbrush in the bathroom and use before they brush their teeth.

What treatment will my child need? Preventers

Brown inhaler

Your doctor or nurse may prescribe another type of inhaler which is usually brown in colour and taken every day even when your child is well. This inhaler is often referred to as a preventer inhaler and belongs to a group of medicines called steroids.
Steroid inhalers reduce inflammation inside your child’s airways. This is usually given if your child has had a number of wheezy episodes or symptoms of cough and wheeze in between viral infections. It is important this medicine is always given using a spacer device with or without a mask and your doctor or nurse should show you how to use this correctly. You should wash around your child’s mouth and nose and clean their teeth or give them a drink after this medicine.
There are other medications your doctor or nurse may prescribe and it is important to understand what these medicines are for and how they work. If you have any questions ask your GP, nurse or pharmacist.

What treatment will my child need? Relievers

Girl using an aerochamber

Your doctor or nurse may prescribe an inhaler called Salbutamol.

Salbutamol belongs to a group of medications called ‘bronchodilators’, these are usually blue in colour and often referred to as ‘reliever’ inhalers.

This inhaler contains a medicine to relax or open the airways and relieve the wheezy symptoms.

Important

It is important this medicine is always given using a spacer device with or without a mask depending on your child’s age and ability. Your doctor or nurse should show you and your child how to use this correctly.

Does this wheeze mean my child has asthma?

Child in bed coughing

Estimates vary but around 1 in 11 or 1 in 13 children in the UK have asthma. This means the majority of children with wheeze caused by viruses will ‘grow out’ of their symptoms by school age.
Children with asthma are often wheezy and have symptoms even when they don’t have a cold, for example with exercise or if they are around pets.
Children with asthma often have other allergic conditions, for example eczema, a food allergy, rhinitis or hayfever.
Children with asthma often have a close family member who has asthma or allergies.
If you are worried your child is having symptoms in between viral infections you should speak to your doctor, nurse or pharmacist to make sure they are on the correct medication.

If the child has a any of the following, make an appointment with your GP for a review.

Regular night-time cough or wheeze.
Symptoms such as wheeze, cough or tight chest on wakening in the morning.
Problems when running around – you should be discus with a health care professional as further medicine may be needed to treat your child’s symptoms.
If your child is already on a blue inhaler and using it more than three times a week this may also suggest different or more medication is needed.

Wheeze

Influenza vaccine

Your child may get wheezy each time they get a cold or they may only become wheezy on one occasion.
Coughs and colds are very common in all young children and it is not unusual for toddlers and young children to get up to 10 colds a year. It can sometimes feel like your child goes from one cold to another.
Usually your child is well in-between viral infections and better over the summer months when there are less coughs and colds around.
Once your child has recovered their immune system will be stronger as they will have developed antibodies to that particular strain of virus.
Flu vaccination is recommended for any child who has a diagnosis of asthma, or been admitted to hospital because of asthma or is on high dose inhaled steroids however final choice is up to parents. All 2-5 years old children will get their flu vaccine at your GP surgery. All children in primary school will receive the flu vaccine. All children with a clinical risk in high school will get their vaccine at your GP surgery.

For more information on vaccines see the section Vaccinations for children with asthma.

Wheeze and your child

Wheeze can be caused by viruses and the common cold and other trigger factors. It is very common. Up to half of all children will have had at least one wheezy episode in their preschool years.
Wheeze is a high pitched or whistling sound that is caused by a cough or cold creating swelling and sticky mucus in the airways. The sound is caused by air that is forced through airways (breathing tubes) that are narrower than normal. The wheeze should improve as the viral infection gets better with treatment.
Wheeze caused by viruses is more common in children under 2 years old as their airways are much smaller than an older child or adult.

Select the play button above to listen to an example of a wheeze.