Recovering From An Asthma Emergency

                                                                                         

Planning for discharge should begin early in the hospitalization process. Your child's regular physician or nurse practitioner should be involved and a follow up visit scheduled soon after discharge. The need for hospitalization suggests that your child's management plan needs to be reassessed. Steroid medicines given by mouth will usually be continued for several days after discharge, and albuterol can be given as needed, usually up to a frequency of a dose every four hours. Your child should continue any controller medicines during this period.

While recovering from a severe asthma flare, it is particularly important to be sure your child avoids asthma triggers like smoke because her airways are inflamed and sensitive. During the days following a severe flare, it is appropriate to rest and avoid physical activity although this should be just for a brief period. You and your doctor should discuss when your child is able to return to school or day care.

Occasionally, a child may respond poorly to treatment and require admission to an intensive care unit. Asthma care in the ICU may include continuous albuterol treatments and intravenous medicines. Children with severe obstruction of their airways are unable to eliminate waste gases like carbon dioxide from the lungs. If these gases build up in the bloodstream, they'll cause a child to become sleepy. As a tired child spends less energy on breathing, the waste gas levels can continue to increase until breathing stops altogether. In these situations, insertion of a breathing tube (intubation) is needed, and the child will be placed on a ventilator. The use of a ventilator is difficult and has many potential complications. Fortunately, the need for this type of treatment is rare as new treatments for asthma have become available.

To summarize, asthma emergencies should generally be preventable by achieving good asthma control with an effective management plan. But even the best efforts sometimes fail and an emergency visit is necessary.

Key points in managing severe flares include:

Early recognition of symptoms

Contacting your regular physician

Seeking care in an appropriate site when symptoms fail to respond as expected

A well-planned and coordinated approach to emergency and hospital treatment will achieve the best success in helping your child get back to good health.

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