Childhood Asthma - Treating Asthma and Asthma Attacks in Children
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Childhood Asthma - Treating Asthma and Asthma Attacks in Children

Asthma is a frightening and painful respiratory condition which can have significant negative impacts on a personÂ’s health in each of the physical, mental and social contexts - and this is particularly so in children. The techniques presented in this article may assist parents, caregivers and the treating team to support children to effectively manage their asthma and asthma attacks.

Asthma is a respiratory condition characterized by periodic inflammation of the airways and serious breathing difficulties. It is a common but chronic disease, typically developing in the early to middle childhood years. If poorly managed, asthma can have significant impacts on a person’s health in each of the physical, mental and social contexts - and this is particularly so in children.

An acute onset of severe asthma - also referred to as an asthma attack - often occurs following the inhalation of an allergenic ‘trigger’. These triggers, which are unique to each person, result in the constriction of the bronchial tube (windpipe) and significant, sometimes life-threatening breathing difficulties. Asthma attacks are typically managed with the administration of high doses of inhaled bronchodilators, medications which relax and expand the windpipe and enable better air entry into the lungs. These medications are delivered in fine particulate form into a face-mask, from which a patient is encouraged to breathe.

Children presenting to an emergency department with an asthma attack, even if they have a history of similar attacks, are often distressed, frightened and in significant pain. Despite acute breathing difficulties, many children refuse to accept inhaled bronchodilators through a face-mask. To younger children in particular, face-masks can seem stifling and may in fact compound to the child’s anxiety and respiratory distress. Additionally, many children dislike the potent smell and taste of the medication within the face-mask, and will often refuse treatment for this reason. There are a number of techniques, however, which may assist parents, caregivers and the treating team to support children as they undergo asthma treatment.

Children must be allowed appropriate freedom to investigate their surroundings to the extent that their condition permits - this will allow them to become more comfortable with the unfamiliar equipment used in the treatment of their asthma. Children may be encouraged to wear their face-mask through the use of a make-believe scenario - for example, pretending to be an astronaut or deep-sea diver. The parent/caregiver/nurse might try the face mask on themselves, demonstrating its safety, or explain to the child the basic functions and features of the mask. Children may be offered juice or flavoured milk to sip periodically as they are inhaling the bronchodilator, both as a reward for wearing the mask and to rid their mouth of the taste of the medication. They may be distracted from the smell of the medication with television, a game or conversation.

The positive future consequences of undergoing treatment - for example, easier breathing and a reduction in chest pain, etc. - must be explained to the child in terms appropriate to their developmental age. Remembering that children are typically unable to think abstractly, caregivers should use language that allows the child to identify with things he or she can physically see and feel – such as the tightness in their chest, for instance. It is important for caregivers to listen to the child’s own self-expression of their symptoms, as this may provide useful information to the effectiveness of the treatment.

Whilst utilizing these techniques, parents/caregivers/nurses must be aware of the importance of recognizing, approving and thus reinforcing the child’s positive behaviours - however minor - in order to encourage the child to continue with the treatment. This will also prevent the likelihood of the child developing frustration or disinterest in the treatment process, and will encourage their active engagement in their own care.  

Asthma is a frightening and painful respiratory condition which can have significant negative impacts on a person’s health in each of the physical, mental and social contexts - and this is particularly so in children. The techniques presented in this article may assist parents, caregivers and the treating team to support children to effectively manage their asthma and asthma attacks.  

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