Asthma is a disorder of the airways of the lungs producing problems in normal may be administered—cromoglycate, or the bronchodilators, or theophyllin. The doctor will work out the best routine for your child. Today, there are various bronchodilators, and they are all good. Aerosol sprays can now rapidly cut short an attack. Salbutamol (“Ventolin”), currently one of the most popular, when inhaled into the airways will hasten relief. Other products are also used.
1. There will be loud, laboured, wheezy breathing.
2. The sufferer has difficulty in speaking and moving.
3. The sufferer is distressed and anxious.
4. Pallor and sweating are marked features.
5. Sometimes, in a severe attack, lack of oxygen leads to mental confusion.
What to Do in the Case of Asthma Attack
1. Sit the patient upright, with arms resting on a pillow, table or chair for support. Open windows, being careful that the patient is not subjected to draughts or chills.
2. In a severe attack seek medical help promptly, as the patient may have to be given oxygen.
3. If the patient has medication specifically prescribed for asthma, it should be given immediately.
4. Speak confidently and reassuringly to the patient, advising that help is on the way. Perhaps a warm drink may help to relieve the tension and fears.
To help the patient easily obtain the full dose of medication, a device called a “spacer” may first receive the dose, which is then inhaled more slowly. These are very effective.
The drugs must not be used haphazardly or too frequently. Despite the fine film of mist the can imparts when the button is pressed, they are very potent drugs. Parental supervision is essential. The doctor’s instructions must be followed implicitly. If relief is not gained within a few minutes, this does not mean fresh sprays are required. Minimum time periods between successive doses are important to avoid overdosing. However, today, the tendency is for patients to under treat rather than over treat asthma.
Cortisone provided a major step forward in the treatment of asthma. With current methods it is being used much less, both in its original form, and its other derivatives, prednisone. prednisolone and beta-methasone. Many adverse side effects occurred with longterm use. But it played its part, and in certain instances is still used. Causing fluid retention, children often develop an odd-shaped appearance called “moon face.” Also, it caused the bones to stop growing, prematurely stunting growth. Many children on long-term steroids have switched to newer methods of therapy.
Other aerosol forms of cortisone-type treatment are now available and they are highly successful in preventing attacks before they occur. Chief of these are beclamethasone (“Becotide” and “Aldecin”). Used regularly, they are highly effective in stopping attacks from occurring. It takes a few weeks for them to become effective. Many children now use this regularly, eliminating the need for oral steroid drugs (the cortisone derivatives).
Other medication that is inhaled is called sodium cromoglycate. It has been around for many years and is also effective in aborting attacks in many instances before they occur. Likewise this must be used regularly. It does not succeed in all cases, but a certain number find it provides good relief.
What about all the other pills and mixtures that choked the medicine cabinet of many asthmatics?
These are now not nearly so necessary. Tininophylline, adrenaline, theophylline and ephedrine are the basis of many. These are still sometimes used, especially for milder asthmatics.
Sometimes skin tests are carried out by allergy specialist to try to discover the most probable cause of the attacks. When it is found, an extract may be prepared that is injected into the patient in increasing doses over a period of 12-18 months. This is aimed at increasing resistance to product. Also, it is hoped to desensitize the patient, as the doctors say. It is still used, but is not popular. Other methods seem easier and more effective.
Keeping house dust to a minimum is advisable. In fact a special kit to help with is now available and is a worthwhile exercise.
Every effort should be made by the parents to eliminate allergy factors to which the child may be sensitive. Hairy, furred pets may precipitate symptoms. Microscopic house dust mites, present in house dust, and often very prolific in bedding, is notorious for causing attacks. Dry-cleaning bedroom curtains, washing bed clothing, vacuuming the bedroom weekly, probably washing the Nankets monthly, using a damp cloth to wipe away settled dust (rather than a dry duster that simply allows dust to re-enter the bedroom air) often help.
Every asthmatic must have a “crisis plan” worked out in conjunction with the doctor well in advance in the event of a sudden asthmatic emergency occurring.
This is of vital importance. How important is the child’s general health?
Ideally, the fitter the child the better. Keeping free from respiratory infections, and indeed infections of any nature, is worth striving for. Eating sensible, regular meals, getting exercise within the child’s capacity, avoiding cigarette smoke (and educating children on the dangers of smoking before they decide to start).
Many children gradually grow out of their asthma, and develop into strong, fit and healthy adults. The attacks become less frequent, and often finally vanish.
A happy, tension-free home environment can only help. Sensible parents will strive to achieve this. In fact it helps all round—parents included!
Today, asthmatic attacks occur with far less frequency and severity than formerly, because new medications are available that stop the attacks from taking over. (See Section 2: Chapter 5.) In the majority of cases a person who develops a sudden attack of asthma will do best with inhalation of one of the “instant action” aerosol preparations especially designed to cut short such an attack.
Occasionally, however, distressingly severe asthma attacks may prove to be life-endangering, so treat promptly.