If your child has asthma, one of your main goals may be to avoid
trips to the emergency room (ER) for breathing problems. That makes
perfect sense, but it's also important to know when going to
the ER is the right choice.
You'll do a better job of making that decision if you
discuss this issue with your child's doctor
your child has a severe
. After discussing it, your instructions should be spelled out in
asthma action plan
. The plan should list
peak flow meter
readings or specific symptoms that will serve as your cue to go to
the ER. If your child is old enough, he or she should know about
these important cues as well.
Signs That Mean You Should Seek Help
Some general signs that indicate you should seek help
by getting to the doctor (or if the doctor isn't available,
getting to the ER or calling an ambulance) include:
- if there are changes in your child's color, like bluish
or gray lips and fingernails
- if your child is having trouble talking
- if you can see the areas between your child's ribs and at
the base of the neck pull in as he or she inhales (these are
- if your child uses his or her
repeatedly for severe flare-up symptoms that don't go away
after 5 or 10 minutes or they return again quickly
- if your child's peak flow reading falls below 50% and
doesn't improve with medication
Make ER Tips Less Stressful
Some advance planning can make trips to the ER less stressful
for you and your child. Here are some ways you can make it a little
- Know the location of your closest emergency room. If
there's a children's hospital ER nearby, use that one and
have the address and phone number for it readily accessible (it
can be written on your child's action plan).
- If you have other children, try to make arrangements with a
relative or other caregiver who can care for them in an emergency
situation. But don't let the lack of a babysitter delay your
trip to the ER. Someone can always come to the hospital and pick
up your other children.
- Take along a copy of your child's asthma action plan or a
note with the names and dosages of any medications your child is
taking, so that you can inform the medical staff at the emergency
Well-managed asthma is rarely life threatening. People who have
died from asthma usually haven't taken their medications as
prescribed and have a history of repeated severe asthma flare-ups
and emergency care. If you and your child take asthma seriously and
work to manage it, you can reduce the chances that your child will
need to go to the emergency room.
Here are some steps to take:
Follow Your Child's Asthma Action Plan
It's important to monitor your child's asthma using a
written plan your child's doctor has helped you create. This
plan will outline your child's day-to-day treatment, list
symptoms to watch for, and give detailed, step-by-step instructions
to follow when your child has a flare-up.
Help Your Child Avoid Triggers
Your child's doctor should be able to help you identify the
that can cause asthma flare-ups. These may include animals, dust
mites, mold, tobacco smoke, cold air, exercise, and infections.
Make Sure Your Child Takes the Controller Medications
Your child should take these medications as prescribed by the
doctor, even when he or she is feeling fine. Skipping
can cause the lungs to become more inflamed, which can lead to a
decrease in lung function. (This can happen without your child even
experiencing any symptoms). It also puts the child at risk for more
frequent and severe flare-ups.
Keep Rescue Medications With Your Child
Many kids must go to the emergency room simply because they
didn't have their rescue medications handy. Your child should
have his or her rescue medication accessible at all times.
Make Your Child a Partner in Asthma Management
As soon as your child is old enough, make sure he or she
understands the asthma action plan and the importance of following
it. Some children with asthma, especially teens, resist taking
controller medications and rely instead on their rescue medications
to help them on an as-needed basis. This is
a good idea and will increase your child's chances of needing
Know the Early Signs of a Flare-Up
Every child's asthma is different. Some children cough only
at night, but others have flare-ups whenever they get a cold or
exercise outside. Get to know your child's asthma and pay
attention to what happens before he or she has a flare-up, so that
you know the early warning signs. These signs may not definitively
mean that a flare-up will happen, but they can help you to plan
A peak flow meter is an extremely useful tool in helping to
determine if your child might be getting ready for a flare-up. Your
doctor can give you specific number ranges to look for.
Other early warning signs of a flare-up may include:
- coughing, even if your child has no cold
- tightness in the chest
- throat clearing
- rapid or irregular breathing
- inability to stand or sit still
- unusual fatigue
- restless sleep
Maintain Communications With the Doctor
Be sure to call him or her at the early sign of a flare-up if
you have any concerns. Being proactive means you may keep your
child's symptoms from worsening and can make a trip to the
doctor's office instead of the emergency room.
Elana Pearl Ben-Joseph, MD
Date reviewed: April 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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