Symptoms

• Symptoms of an asthma attack are wheezing, a cough, tight chest, and trouble breathing.
• Wheezing is the classic symptom. Wheezing is a high-pitched whistling or purring sound.  You can hear it best when your child is breathing out.

Causes (Triggers) of Asthma Attacks

• Infections that affect breathing (like colds or the flu)
• Pollens
• Animals (like cats)
• Tobacco smoke
• Irritants (such as smog, car exhaust, menthol vapors, barns, dirty basement)
• Asthma attacks caused by food allergy can be life-threatening

Asthma Attack Scale

• Mild: No Shortness of Breath (SOB) at rest. Mild SOB with walking. Can talk normally. Speaks in sentences. Can lay down flat. Wheezes not heard. (GREEN Zone: Peak Flow Rate 80-100% of normal rate)
• Moderate: SOB at rest. Speaks in phrases. Wants to sit (can't lay down flat). Wheezing can be heard. (YELLOW Zone: Peak Flow Rate 50-80% of normal rate)
• Severe: Severe SOB at rest. Speaks in single words. Struggling to breathe. Wheezing may be loud. (RED Zone: Peak Flow Rate less than 50% of normal rate)

1. What You Should Know:
   • Over 10% of children have asthma.
   • Your child's asthma can flare up at any time.
   • When you are away from your home, always take your child's medicines with you.
   • The sooner you start treatment, the faster your child will feel better.
   • Here is some care advice that should help.
2. Asthma Quick-Relief Medicine:
   • Your child's quick-relief (rescue) medicine is albuterol or xopenex.
   • Start it at the first sign of any wheezing, shortness of breath or hard coughing.
   • Give by inhaler with a spacer (2 puffs each time) or use a neb machine.
   • Repeat it every 4 hours if your child is having any asthma symptoms.
   • Never give it more often than 4 hours without talking with your child's doctor.
   • Coughing. The best "cough med" for a child with asthma is always the asthma medicine. (Caution: don't use cough suppressants. If over 6 years old, cough drops may help a tickly cough.)
   • Caution: If the inhaler hasn't been used in over 7 days, prime it. Test spray it twice into the air before using it for treatment. Also, do this if it is new.
   • Use the medicine until your child has not wheezed or coughed for 48 hours.
   • Spacer. Always use inhalers with a spacer. It will get twice the amount of medicine into the lungs.
3. Asthma Controller Medicine:
   • Your child may have been told to use a controller drug. Examples are inhaled steroids or cromolyn.
   • During asthma attacks, keep giving this medicine to your child as ordered.
4. Hay Fever:
   • For signs of nasal allergies (hay fever), it's okay to give allergy medicine. Reason: Poor control of nasal allergies makes asthma worse.
5. Fluids:
   • Try to get your child to drink lots of fluids.
   • Goal: Keep your child well hydrated.
   • Reason: It will loosen up any phlegm in the lungs. Then it's easier to cough up.
6. Humidifier:
   • If the air in your home is dry, use a humidifier. Reason: Dry air makes coughs worse.
7. Avoid or Remove Allergens:
   • Shower to remove pollens or other allergens from the body and hair.
   • Avoid known causes of asthma attacks (such as smoke or cats).
   • Do not take part in sports during the attack.
8. What to Expect:
   • If treatment is started early, most asthma attacks are quickly brought under control.
   • All wheezing should be gone by 5 days.
9. Call Your Doctor If:
   • Trouble breathing occurs
   • Asthma quick-relief medicine (neb or inhaler) is needed more than every 4 hours
   • Wheezing lasts over 24 hours
   • Your child becomes worse