Acute Asthma In Under 5s

Asthma can occur at any age but in childhood it can be very problematic as the child is unable to understand and co-operate at such an age.

Causes of asthma

There may be same causes as in the case of adults such as airborne pollens, house dust (mites), feather pillows, animal dander, smoke and other pollutants or infections (more commonly viral) of the respiratory tract.

Symptoms

The child becomes too severely breathless to talk or even feed. He may become agitated and drowsy. The respiration rate also increases over 50 per minute (normal respiration rate in children over 5 years is more than or equal to 40 per minute). Extensive wheeze may be heard or there may be silent chest. In severe cases, cyanosis may also appear.

Pulse rate also increases to 140 beats per minute or even higher (normal pulse rate in children uptill 5 years of age is more than or equal to 120 beats per minute). In younger children, there is dyspnoea (difficulty in breathing) with the use of accessory muscles of breathing in such scenarios. In older children, peak flow becomes less than or equal to half of the best.

Treatment

In case of signs of acute asthmatic attack, you must immediately arrange for hospitalization of the child.

General measures include administration of oxygen or mixture of helium and oxygen may also be given. Never hesitate for intubation or ventilation support for the child if needed because it is always better than post mortem analysis. Prolonged expiration phase must be allowed so as to prevent the development of carbon dioxide retention and respiratory acidosis.

In case of acute asthma, try continuous nebulization. Steroids are prescribed along with.

With improvement of symptoms, usual treatment with steroids must be continued. Constant monitoring of the patient must be done and self-management should be discussed with the patient.