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What to do if my child is having an asthma attack?
If your child has an asthma attack it is an emergency
You may notice the following symptoms
- Chest tightness
- Shortness of breath
- Faster breathing
- Cough
- Wheeze
- Making more effort to breath, such as using ‘tummy muscles’ or sucking in the spaces between ribs or under the breast bone
- The reliever (blue inhaler) does not help
Follow the Red, Amber, and Green sections below.
If your child:
- has blue lips
- or is unresponsive or very irritable
- or is struggling to breathe - pulling in of the chest or neck muscles - using tummy muscles
- or has unusually long pauses in breathing
- or has an irregular breathing pattern
- or is unable to swallow or is drooling
- is too breathless to feed or speak
- is unable to take fluids
- is pale, drowsy, weak or quiet
You need urgent help.
Go to the nearest Hospital Emergency (A&E) Department or phone 999
If you have a blue inhaler use it now, 1 puff per minute via spacer until ambulance arrives. Keep child sitting up and try to remain calm
If your child has any one of these features;
- Appears to be getting worse or you are worried
- Restless or irritable
- Increased difficulty in breathing such as - Rapid breathing - Taking more effort to breathe - Flaring of nostrils
- Becoming unusually pale
- Temperature of 39°C despite paracetamol and/or ibuprofen
- Reduced fluid intake by half usual amount
- Passed urine less than twice in 12 hours
- Vomiting
- Mild wheeze and breathlessness not helped by usual reliever (blue inhaler)
You need to contact a doctor or nurse today.
Please ring your GP surgery or call NHS 111 - dial 111
Increase blue inhaler to 10 puffs over 20 minutes and repeat every 4 hours via a spacer
If none of the features in the red or amber boxes above are present
If your child is using their reliever more than usual or more than 3x/ week but is;
- Not breathing quickly
- Can continue doing daily activities
- Able to talk in full sentences
Self care
Needs a medical review within the next 48-72 hours. Continue to use your blue inhaler as required. If you feel you need more advice, please contact your local pharmacy, Health Visitor or GP surgery. You can also call NHS 111 for advice.
Post-attack plan
Your child should now be improving as a result of the steroid medication they have been given. The need for salbutamol (the blue reliever inhaler, used with a spacer) should be reducing.
- Take the preventer medication as prescribed by the health professional, according to your personalised asthma action plan.
- Take the blue reliever inhaler as needed if your child has any symptoms. Give 2 puffs, one at time and wait 2 minutes, repeat if necessary until you have given up to 6 puffs. The symptoms should have disappeared. The effects should last for at least 4 hours.
- If your child needs the blue reliever inhaler more than every four hours, your child’s asthma attack is not controlled and you need to take emergency action now. Take up to 10 puffs and seek urgent medical attention either by arranging an urgent appointment with your GP or if it is closed call 111.
- If your child is having difficulty breathing not relieved by 10 puffs of salbutamol or is requiring repeated doses of 10 puffs you should call 999.
Important
Your child should have a review within 48 hours of discharge from hospital to review their progress. A full review of their asthma management should take place within 4 weeks of discharge.
After Hospital Discharge
If your child has been treated in hospital for their asthma, they should be seen by their own GP or practice nurse within 48 hours of being discharged from hospital. It is important to take your child’s spacer and asthma medication as well as the personalised asthma action plan if you have one and a copy of your hospital discharge letter.
What happens at the review?
- To check your child’s symptoms are improving
- If your child has been given oral steroids in hospital these are usually continued for 3-5 days but some may need to continue these for longer.
- Review your child’s reliever inhaler acute management plan
- Check your child’s inhaler technique
- Review any preventer medication Identify and discuss any triggers for the attack
- Assess how the attack was managed at home
- Offer help for any adults who have contact with your child to stop smoking
- Update or create a personalised asthma action plan for your child.
Caring for your child at home
If your child does not have any red or amber symptoms in the traffic light advice then you can care for your child at home. Make sure your child takes their treatment as directed. If symptoms get worse or don’t improve seek medical advice.
Make sure your child is never exposed to tobacco smoke. Passive smoking can seriously damage children’s health. It can make breathing problems like asthma worse. Remember, smoke remains on your clothes when you smoke anywhere, including outside. You can find out how to get help to stop smoking on www.nhs.uk/smokefree
Asthma Reviews
Your asthma should be reviewed;
- At least every 12 months
- After an exacerbation of asthma
- 48 hours after a hospital admission
For wear and tear, minor trips and everything in between.
Self-care
You can treat your child's very minor illnesses and injuries at home.
Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.
Sound advice
Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.
For information on common childhood illnesses go to What is wrong with my child?
Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.
Sound advice
- Visit a pharmacy if your child is ill, but does not need to see a GP.
- Remember that if your child's condition gets worse, you should seek further medical advice immediately.
- Help your child to understand - watch this video with them about going to the pharmacy.
For information on common childhood illnesses go to What is wrong with my child?
Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.
Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.
Contact them by phoning your Health Visitor Team or local Children’s Centre.
Sound advice
Health visitors also provide advice, support and guidance in caring for your child, including:
- Breastfeeding, weaning and healthy eating
- Exercise, hygiene and safety
- Your child’s growth and development
- Emotional health and wellbeing, including postnatal depression
- Safety in the home
- Stopping smoking
- Contraception and sexual health
- Sleep and behaviour management (including temper tantrums!)
- Toilet training
- Minor illnesses
For more information watch the video: What does a health visitor do?
School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.
There is also a specialist nurse who works with families who choose to educate their children at home.
Sound Advice
Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.
They all have a role in preventing disease and promoting health and wellbeing, by:-
- encouraging healthier lifestyles
- offering immunisations
- giving information, advice and support to children, young people and their families
- supporting children with complex health needs
Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.
GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.
Sound advice
You have a choice of service:
- Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
- Help your child to understand – watch this video with them about visiting the GP or going to a walk in centre
For information on common childhood illnesses go to What is wrong with my child?
If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.
Sound advice
Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.
For information on common childhood illnesses go to What is wrong with my child?
A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.