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Early Signs of Asthma But Parents Delay Treatment 
ACAAI > News > Early Signs of Asthma But Parents Delay Treatment
 

According to Doctor Jane Garbutt, MBChB parents of young asthmatic children, age 2-10 accurately recognized the onset of an attack of asthma, at least 80% of the time. They noted an increase in respiratory symptoms such as cough, shortness of breath, and wheeze along with non-specific changes including change in behavior, vomiting, and dark circles under the eyes. The early warning signs were usually the same with each exacerbation of asthma. The use of objective monitoring, e.g. measuring lung function using a peak flow meter or keeping a symptom diary was reported less than 25% of the time. However, even when recognizing these early signs and symptoms of asthma, parents often delayed increasing the intensity of the asthma treatment, at times until the child was gasping for breath or using accessory muscles for breathing.

When starting treatment for an asthma attack, parents usually administer albuterol, a bronchodilator used for quick relief, but rarely do they add a controller medication, e.g. oral corticosteroids.

Less than 50% of the parents in this study reported to have and to use the child's Asthma Action Plan, a written plan outlining what steps to take in the event of an attack of asthma. However, when used, 93% of parents found it to be very useful. It has been strongly recommended by the National Asthma Education and Prevention Program guidelines that all asthmatics develop their own specific action plan in partnership with their personal physician.

The early home use of oral corticosteroids, the most effective controller medication for an asthma attack, continues to be a major problem despite availability of these medications at home, consultation with the physician by phone, and previous use of these medications.

The authors recommend that parents of young asthmatic children:

  • Use both subjective (listening for cough) and objective (measurement of peak flow) monitoring of asthma on a regular basis
  • Use an Asthma Action Plan, developed and reviewed with their personal physician on a regular basis, for all asthma attacks
  • Have on-hand and current the medications listed in the asthma action plan, e.g. oral corticosteroids and bronchodilators
  • Recognize the signs and symptoms in their child that indicate that an asthma attack is starting
  • Act early to start a controller medication, usually an oral corticosteroid, in addition to their quick relief bronchodilator and to contact their physician
  • Avoid the use of over-the-counter cough and cold medications
  • Prescribed antihistamines for allergies may be continued but are unlikely to benefit the asthma attack
  • Young children not using a nebulizer for at home medication delivery may benefit from a holding chamber attached to the metered-dose inhaler
  • Seek immediate help, unscheduled office visit or emergency department visit, any time asthma attack symptoms are rapidly worsening or the child is not responding to treatment.

Please click here for the full abstract (free) or purchase the complete journal article.

 
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