Author Archives: Jackie Aim

What to say to children

Family looking at a laptop computer

Family looking at a laptop computer

The key messages are:

  • Get your child to tell you when they are feeling unwell and know the signs to look for.
  • Tell them that if they take inhalers as soon as they feel unwell the asthma attack will most likely go away.
  • Young children can’t always tell you how they feel so you need to be observant and look for any early warning signs. Act on them by following your child’s asthma action plan.
  • Make sure you tell anyone who cares for your child when you are not there, such as school, friends, childminders, other parents, family members, how to use the inhalers and how to get in touch with you if they are worried. If you know your child’s early warning signs tell them what to look for and what to do. Tell your child that their other carers also know what to do so they will be safe even if you are not there.
  • Reassure that if they are keeping active and taking regular medicine to prevent asthma and their asthma is controlled,  they are protected.
  • If your child is still worried or anxious ask for help and guidance from your GP , practice nurse or specialist.

Visit the topic Wheeze and your child to listen to an example of a wheeze.

Avoidable factors

Examples of asthma plans

Examples of asthma plans

Recent research shows that most people who died of an asthma attack had an “avoidable factor” identified after their death. Avoidable factors are things you can have some influence over to help minimise the risk of a life threatening asthma attack.

  • Go for review at least once or twice a year – even if your child is well.
  • Remember to give preventer inhalers regularly.
  • Try to stay away from known triggers.
  • Stay alert to any changes in your child’s health.
  • If you are at all unsure about your child’s asthma – get advice from your GP, practice nurse or asthma team.
  • Follow your child’s asthma control plan.

If you think your child is having a flare up of their asthma, give the blue reliever inhaler and have them checked out by a doctor or nurse early so we can stop things getting worse.

Discussing life threatening asthma

Teenage girl making daisy chain

Teenage girl making daisy chain


If you have experience of someone who has died of asthma, it may be especially frightening for you and your child. It is difficult to reassure children and families at such a difficult time.

Your child may hear or see reports on television, radio or social media when a child or adult has died after an asthma attack. They may be frightened or confused. They may want to ask you about it. You can give reassurance by teaching them about the importance of what good asthma care means.

Here are some things for you think about on the following pages.

How to give oral steroids to a child

  • If your child is co-operative and they can swallow tablets, give the daily dose as soon as they wake up in the morning.
  • If they can’t swallow tablets, doctors usually prescribe pink dissolving tablets. Try to dissolve all the tablets in a small amount of lukewarm water as that helps them to dissolve completely. No more than 1 teaspoonful. This is because the oral steroids taste horrible and children don’t usually like taking them, so you have to give a very small amount or they won’t finish the dose.
  • Don’t mask the taste by putting them in their drink or bottle as you can put them off their favourite drink and fail to get the dose of steroid into their system.
  • You can give a drink after they have taken the steroids.

For advice on how to give your child tablets see the video below:

Video from Medicines for children.

Self management

Remember during this time you need to continue to give the blue reliever inhaler every 4 hours.Don’t stop or cut down the puffs too soon.They may still have a trigger hanging around and still have tight muscles around their airways.

Oral Steroids

Prednisolone tablets

Prednisolone tablets

  • If your doctor or nurse gives you a course of oral steroids for your child, you should give the first dose immediately.
  • Don’t delay the dose and don’t split it up over the day.
  • Oral steroids (prednisolone) act in the same way as the brown preventer inhaler – they damp down the inflammation in your child’s airways.
  • The oral steroids work in 4 hours!
  • The usual dose of oral steroids for a child is based on their age and is given as a daily dose.

Self management

It is vital that your child completes the whole course to make sure all the inflammation settles.

During an asthma attack

© Crown copyright 2014

© Crown copyright 2014

10 puffs of blue reliever inhaler through a spacer is similar to giving a nebuliser, and can be effective in treating children. You should still get your child checked even if they have settled and appear to be better.

You might think “but I don’t want to bother the doctor!” as you think the child has settled! All that has happened is that you have relaxed the tight muscles around the airways and given them some relief.

Remember

If your child needs to have 10 puffs of blue reliever inhaler through a spacer for symptoms then they need review by a doctor or nurse. Don’t stay at home! Have your child reviewed.

Knowing when to get emergency help

cartoon_ambulance

If you have given 10 puffs of their reliever inhaler and they are still no better your child will need emergency help. Call 999.
Any of these symptoms are an emergency:

  • Distressed.
  • Gasping for breath.
  • Neck and tummy sucking in when breathing.
  • Unable to eat or drink.
  • Finding it hard to speak.
  • Looking pale or their lips going blue.
  • Quiet or drowsy.
  • Seem muddled or confused.

If you notice any of these, or if you are very worried about your child’s breathing you should call 999 for an ambulance straight away.Remember – Don’t be afraid to make a fuss!

When you call 999 you will be asked:

  • Your name.
  • Your child’s name.
  • Your address.
  • Your GP.
  • Describe your child’s symptoms and any medicine you have given to the child.

The operator can give you instructions while you are on the phone while help is on the way.

Important

While you are waiting for the ambulance:

  • Stay calm. Keep your child sitting up straight. Loosen any tight clothing and avoid putting your arm around the child, instead hold their hand for comfort. Talk to your child in a soothing way.
  • Give your child 10 puffs of their reliever using a spacer (1 puff at a time – your child should take 5 breaths for each puff).
  • Keep giving the reliever every few minutes until the ambulance arrives.

When you take your child to a doctor

Child/ girl being shown how to use volumatic inhaler to treat asthma. Mother and nurse.

© Crown copyright 2014

  • When seen by the doctor or nurse, ensure your child has their oxygen level checked.
  • They also need to have the air entry to their lungs checked with a stethoscope as part of the review.
  • They are highly likely to need a course of oral steroids (prednisolone) to settle down the inflammations.

Important

This cannot and must not be done over the phone – a doctor or nurse practitioner needs to review and assess your child in person.

Treating an asthma attack

Important

Give your child 10 puffs of their blue reliever inhaler through a spacer device. You would expect to see some relief after 10 minutes. If your child is still struggling after this dose call 999 for an ambulance and continue to give a puff of their reliever inhaler every minute until help arrives.

If the 10 puffs dose is working and your child is responding you should still arrange an urgent medical review at either your GP or NHS 24 (phone 111) depending on the time of day. Stay with the child , give reassurance and continue to observe them until fully recovered.

You are usually able to wait a short time to be seen if needed as you have caught your child’s symptoms quickly and have given them the appropriate first aid treatment.