Responding to an Asthma Attack

It can be frightening to watch your child experience an asthma attack. With all the possible triggers that can start this type of labored breathing, it may be difficult to know what to avoid and how to respond to this type of situation. Thankfully, our pediatricians in Marietta, Georgia are here to help!

Use this guide only if a doctor has told you your child has asthma.

Signs and Symptoms of Asthma

Symptoms of an asthma attack are wheezing, a cough, tight chest, and trouble breathing.

Wheezing is the classic symptom. Wheezing is a high-pitched whistling or purring sound. You can hear it best when your child is breathing out.

The diagnosis of asthma requires attacks of wheezing that recur. The diagnosis is rarely made before 1 year of age.

Causes (Triggers) of Asthma Attacks

  • Infections that affect breathing (like colds or the flu)
  • Pollens (trees, grass and weeds)
  • Animals (like cats or rabbits)
  • Tobacco smoke
  • Irritants (such as smog, car exhaust, menthol vapors, barns, dirty basement)
  • Food Allergy (Serious). Asthma attacks caused by food allergy can be life-threatening (anaphylaxis). Examples are nuts or fish.

Asthma Attack Scale

  • Mild: No Shortness of Breath (SOB) at rest. Mild SOB with walking. Can talk normally. Speaks in sentences. Can lay down flat. Wheezes not heard or mild. (Green Zone: Peak Flow Rate 80-100% of normal rate)
  • Moderate: SOB at rest. Speaks in phrases. Wants to sit (can’t lay down flat). Wheezing can be heard. Retractions are present (ribs pull in with each breath). (Yellow Zone: Peak Flow Rate 50-80% of normal rate)
  • Severe: Severe SOB at rest. Speaks in single words. Struggling to breathe. Wheezing may be loud. Rarely, wheezing is absent due to poor air movement. Retractions may be severe. (Red Zone: Peak Flow Rate less than 50% of normal rate)
  • Peak Flow Meter: A peak flow meter measures Peak Flow Rates (PFR). It tells us how well a person can move air out of the lungs. A PFR can be used in children 6 years and older.

When to Call Cobb Pediatrics About an Asthma Attack

Call 911 Now

  • Wheezing and life-threatening allergic reaction to similar substance in the past
  • Starts to wheeze suddenly after bee sting, taking a new medicine, or allergic food
  • Severe trouble breathing (struggling for each breath, can barely speak or cry)
  • Passed out
  • Lips or face are bluish when not coughing
  • You think your child has a life-threatening emergency

Call Cobb Pediatrics Within 24 Hours

  • Mild wheezing lasts over 24 hours on neb or inhaler treatments
  • Sinus pain (not just congestion)
  • Fever lasts more than 3 days
  • Fever returns after gone for more than 24 hours
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor Now or Go to ER

  • Lips or face have turned bluish during coughing
  • Ribs are pulling in with each breath (retractions)
  • Peak flow rate 50-80% of normal rate after using neb or inhaler (Yellow Zone)
  • Wheezing not gone 20 minutes after using neb or inhaler
  • Breathing much faster than normal
  • Nonstop coughing not improved after using neb or inhaler
  • Severe chest pain
  • Need to use asthma medicine (neb or inhaler) more often than every 4 hours
  • Fever over 104° F (40° C)
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent
     

Call Your Pediatrician During Office Hours

  • Don’t have written asthma action plan from your doctor
  • Use an inhaler, but don’t have a spacer
  • Miss more than 1 day of school per month for asthma
  • Asthma limits exercise or sports
  • Asthma attacks wake child up from sleep
  • Use more than 1 inhaler per month
  • No asthma check-up in over 1 year
  • You have other questions or concerns

Self Care at Home

  • Mild asthma attack

View Asthma Attack Treatment Options

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