Asthma Attack (asthma suddenly gets worse)

If your child’s asthma suddenly gets much worse (asthma attack), they will require urgent treatment.

Signs of an asthma attack include: 

  • Sounding very wheezy
  • Having a tight chest
  • Finding it hard to breath
  • Being too breathless to speak is a sign of a severe asthma attack and needs emergency treatment

Sometimes there is no obvious cause for your child’s asthma attack, but the most common triggers are viral infections (coughs, colds and chest infections), sudden changes in the weather and exposure to cigarette smoke.

Asthma attack (asthma suddenly gets worse)

Asthma attack advice for parents and carers | Healthier Together | (nenc-healthiertogether.nhs.uk)

Asthma attack (asthma suddenly gets worse)

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If your child has any of the following:

  • Too breathless to talk/eat or drink 
  • Has blue lips
  • Having symptoms of cough/wheeze or breathlessness which are getting worse despite 10 puffs blue (salbutamol) inhaler every 4 hours 
  • Breathing very fast or breathing that stops or pauses
  • Working hard to breathe, drawing in of the muscles below the rib, unable to talk or noisy breathing (grunting)
  • Becomes pale, blue, mottled and/or unusually cold to touch
  • Difficult to wake up, very sleepy or confused
  • Weak, high-pitched, continuous cry or extremely agitated
  • Has a fit (seizure)
  • A temperature less than 36oC or temperature 38oC or more if baby is less than 3 months
  • Develops a rash that does not disappear with pressure and seems unwell (see the 'Glass Test')

You need urgent help. Call 999

Give 10 puffs of blue (salbutamol) reliever inhaler every 10 minutes until ambulance arrives.

Keep child in upright position and reassure them.

If your child has any of the following:

  • Blue (salbutamol) inhaler 2-5 puffs via a spacer is not lasting 4 hours
  • Cough or wheeze/tight chest during the day and night
  • Too breathless to run/play/do normal activities
  • Breathing a bit faster than normal or working a bit harder to breathe
  • Dry skin, lips, tongue or looking pale
  • Not had a wee or wet nappy in last 12 hours
  • Sleepy or not responding normally
  • Crying and unsettled
  • Not drinking
  • A temperature 39oC or above in babies 3-6 months
  • Temperature of 38oC or above for more than 5 days or shivering with fever (rigors)
  • Getting worse or you are worried about them

Immediately contact your GP and make an appointment for your child to be seen that day face to face

Increase blue (salbutamol) reliever inhaler 6-10 puffs every 4 hours.

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, then consider taking them to your nearest Emergency Department

If your child has none of the above:

Watch them closely for any change and look out for any red or amber symptom

Self care

Give 2-5 puffs blue (salbutamol) reliever inhaler every 4 hours until symptoms improve

This guidance has been reviewed and adapted by healthcare professionals across North East and North Cumbria with consent from the Hampshire development groups.

This guidance is written by healthcare professionals from across Hampshire, Dorset and the Isle of Wight.

Although your child has not been diagnosed with asthma, your GP asthma nurse will usually be happy to review children with viral induced wheeze. If your child has been discharged from hospital, you should arrange for them to be seen in the next 48 hours by your GP or GP practice nurse. You should arrange for them to be reviewed by your GP if they continue to have lots of problems with wheeze once they have recovered from their cold.

Choose appropriate sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath)

  1. Shake the inhaler well and remove cap
  2. Fit the inhaler into the opening at the end of the spacer
  3. Place mask over the child’s face ensuring a good seal
  4. Press the inhaler once and allow the child to take 5 slow tidal breaths between each dose
  5. Remove the inhaler and shake between every puff

Repeat steps 2 – 5 for subsequent doses

Plastic spacers should be washed before 1st use and every month as per manufacturer’s guidelines

 

 

 

For videos on using your child’s inhaler and spacer correctly see goo.gl/235DQf

Control your child’s Asthma Children with poorly controlled asthma are much more likely to have an asthma attack compared to children's whose is well controlled. Signs of poorly controlled asthma include:

  • your child having a regular cough at night (nocturnal cough),
  • being wheezy or more breathless than other children when they run around or
  • using their reliever inhaler more often than expected.

Arrange to see your GP or asthma nurse if they are experiencing such symptoms. Help your child use their inhalers correctly Choose an appropriately sized spacer with mask (or mouthpiece if child is over 3 years with good technique and is not significantly short of breath).

  1. Shake the inhaler well and remove cap.
  2. Fit the inhaler into the opening at the end of the spacer.
  3. Place mask over the child's face or mouthpiece in their mouth ensuring a good seal.
  4. Press the inhaler once and allow the child to take slow breaths or slow count to 10 between each dose.
  5. Remove the inhaler and shake between every puff. Wait 1 minute between puffs.

Repeat steps 1-5 for subsequent doses.

Plastic spacers should be washed before 1st use and every month as per manufacturer's guidelines.

For videos on using your child's inhaler and spacer correctly visit Beat Asthma and select video from the top menu.

Avoid triggers where possible:

Although it is extremely difficult to avoid your child getting a viral infection or experiencing changes in the weather, you can reduce exposure to common irritants such as cigarette smoke. Even where adults smoke away from their children, smoke on their clothes and hair is likely to make their child’s asthma worse.

Your child should have an influenza immunisation every autumn (the flu jab).

Not only can flu trigger an asthma attack in your child, your child is more likely to experience severe influenza if they have asthma. Protect them by having them vaccinated every year