Fresh Air Is Only Great If You Actually Can Breathe It!

"The good news is that fewer children are dying of asthma; the bad news is that it remains one of the leading causes of childhood hospitalizations," said Jay Kaplan, MD, FACEP, president of ACEP.  "Spring is an ideal time to put together an asthma management plan with your doctor, which should include the fall allergy and winter flu seasons as well."

About 1.8 million emergency visits occur every year because of asthma. If you are not sure whether your child has asthma, but he or she has the symptoms of asthma (coughing, wheezing, shortness of breath), talk to your doctor. After a child has been diagnosed with asthma, the parent or guardian and child should meet with a physician to develop a plan for monitoring asthma symptoms (usually a peak flow meter) and for medicating the child when trouble develops. 

Some children with asthma will benefit from two types of medication: one they use daily to prevent asthma attacks ("controller" medications or inhalers), and one they use to relieve symptoms ("rescue" inhalers). Children with asthma should carry a rescue inhaler with them or have one readily available to them at school. It is important that when children develop symptoms, they and their caregivers or teachers know how to administer the medication and do so quickly.

Consistent use of controller medications can prevent many asthma attacks and help children lead a normal, physically active life. How and when medications are used may vary from season to season, depending on what an individual child's triggers are. 

Typical triggers are:

• Exercise
• Colds and flu
• Laughing or crying hard
• Allergens from plants, animals, house dust, cockroach droppings or mold
• Irritants such as cold air, chemicals and smoke

Dr. Kaplan recommends that you do what you can to limit your child's exposure to his or her asthma triggers. For example, if your child is allergic to furry animals, minimize his or her exposure to them at friends' houses and in the classroom at school. If cold air is a trigger, arrange for your child to exercise indoors during the winter instead of outdoors. If dust is a trigger, replace carpeting with wood, tile or vinyl floor coverings.
 
Be sure to get your child a flu shot as soon as they are available in the fall. 

Even with the best planning, some children will have asthma attacks that require immediate attention from an emergency physician at the emergency department. The following conditions should prompt a call for emergency help (911 in most areas):

• Symptoms do not improve quickly after the use of rescue inhalers.
• The child strains to breathe or cannot complete a sentence without pausing for breath.
• The child's lips or fingernails turn blue.

Older children (ages 11-17) have the lowest rate of emergency department visits, but the highest rate of death from asthma.  It suggests that although they are more independent than younger children in many areas, they still need close monitoring by their parents for signs that their asthma symptoms are worsening and in need of medical attention.

"Emergency physicians want your children to lead fully active, energetic lives without visiting the emergency department," said Dr. Kaplan.  "However, if your child is in trouble, we will be there to get him or her back in action as quickly as possible.

ACEP is the national medical specialty society representing emergency medicine. ACEP is committed to advancing emergency care through continuing education, research and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. 

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SOURCE American College of Emergency Physicians (ACEP)

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