Managing asthma in children
No one really knows why kids get asthma, as it tends to run in families. This means if a child has asthma, he or she might have a parent, sibling, or another relative who has asthma or had it as a child, says Dr. Sylvester Dode, a Paediatrician with the Ellz Women and Children Hospital in Lagos.
According to him, asthma is a chronic lung disorder that causes airways (the tubes that carry air into and out of the lungs) to become inflamed, which means that they swell and produce lots of thick mucus. The muscles surrounding the airways also tend to tighten, which makes the already clogged airways even narrower.
This results in asthma symptoms, which can include coughing, wheezing, and shortness of breath. In a person with asthma, the airways are overly sensitive to certain things such as allergies, viral infections, cold air, exercise, and smoke, which can trigger or bring on asthma symptoms. People with asthma often find that their symptoms come and go – when the symptoms are present, it’s known as a flare, flare-up, episode or attack.
Dr. Dode noted that in asthma, the patient takes thousands of breaths every day. “Normally, when you breathe in, air enters your nose or mouth and then goes to the windpipe, also called the trachea. From there, the air travels into the lungs through breathing tubes. The whole process goes in reverse when you exhale. With asthma, breathing gets harder because airways narrow, swell, and fill with mucus. This makes it tough for air to pass through.”
On medical management steps to take, the paediatrician said the child should be given oxygen, give short-acting ß2-agonists, prescribe corticosteroids, and assess treatment response. Oxygen is a treatment for hypoxaemia, not breathlessness. To avoid hypoxemia during changes in treatment, children who are acutely distressed should be treated immediately with oxygen and 2.5 mg of salbutamol or equivalent diluted in 2.5mL of sterile normal saline delivered by a nebulizer.
“Children with severe or life-threatening asthma (SpO2 <92%) should receive frequent doses of nebulised bronchodilators driven by oxygen (2.5–5 mg salbutamol). If there is a poor response to the initial dose of β2 agonists, subsequent doses should be given in combination with nebulised ipratropium bromide. [ad] On myths about asthma, Dr. Dode noted while some people think wheezing, isn’t asthma, the fact is that the absence of wheezing doesn’t mean asthma is inactive. Wheezing is usually audible but sometimes it can only be heard with a stethoscope. Some others say asthma is not a big deal and it’s easily controlled, the fact is that about 10 people each day die from asthma; chronic and incurable disease and millions of more patients and their families are affected by it. Also people think that someone with traces of asthma should not exercise, play sports, the fact is people with asthma are encouraged to lead an active lifestyle including participation in sports and gym classes because a fully active life keeps you and your lungs healthy. It may help with weight control, which is essential in managing asthma. [ad]