Treatment of Pediatric Asthma

April 24, 2014

 Asthma is a chronic inflammatory disease of the airways. The inflammation causes the airways to produce large amounts of mucus. This may cause plugging of the inflamed airways, making it even harder to breathe.

Among children and adolescents aged 5-18 years, asthma is the leading cause of hospital stays and school absences,  accounting for a loss of 14 million school days annually. In recent years there has been a spike in the number of children developing asthma, partly attributed to environmental factors such as air pollution,  indoor pollutants such as animal dander, house dust mites, and fumes from cleaning liquids.

Because a child’s airways are narrower than an adult’s, children have a greater risk of developing airway constriction.

According to  Archana Singh, MD, chief of pediatric pulmonology at The  Children’s Hospital at Saint Peter’s University Hospital, symptoms of asthma in children include:
•   Cough - typically dry and sometimes the only symptom of asthma
•   Wheezing - A high-pitched whistling sound during breathing

Other symptoms can include tightness in the chest, difficulty breathing, poor exercise endurance, and feeling tired.

Saint Peter’s Healthcare System was recently named one of the nation’s Top Performers on Key Quality Measures 2012 by  The Joint Commission, the leading accreditor of healthcare organizations in America. Recognized for exemplary performance in the use of processes attributed to care that leads to positive patient outcomes in the treatment of such conditions a heart attack, heart failure and pneumonia, and surgical care, Saint Peter’s was the only New Jersey hospital cited for quality care of childhood asthma.

At The Children’s Hospital at Saint Peter’s University Hospital, a child suspected of having asthma undergoes thorough examination, evaluation, and tests necessary to confirm diagnosis. Diagnostic tests include allergy testing when allergies are suspected to trigger asthma and a lung function test.
Treatment must include the management of asthma triggers, says Dr. Singh.

 In addition to indoor and outdoor allergies, asthma triggers include:

•    Cigarette smoke
•    Air pollution
•    Acid reflux
•    Infections such as flu and sinus problems
•    Weather - sudden changes in cold or heat
•    Excessive crying or laughing
•    Vocal chord problems

As is the case with adults, medications can be prescribed to treat asthma. Rescue medicines are taken when children are having an asthma attack with symptoms such as coughing, wheezing and/or having trouble breathing. Examples of quick-relief medicines include albuterol, proventil, ventolin, and xopenex.
Long-term control medicines are prescribed to be taken every day so as to prevent asthma symptoms. Children must take these medicines even if no symptoms are present, says Dr. Singh, and some children may need more than one long-term control medicine.
“The goal of asthma treatment should be to use minimum medication necessary to maintain control of the condition and prevent long-term lung damage,” says Dr. Singh.
Because management is so important to controlling symptoms, it is important that parents work with their child’s school to attempt to minimize the absences related to asthma. School nursing offices should have a copy of a child’s asthma management plan, says Dr. Singh. Parents usually sign consent so children will be able to take medicine  during school hours.
According to New Jersey school laws and regulations, school districts allow students    to self-administer emergency asthma medication if approved to do so by a physician. The law also requires schools to have a nebulizer on-site.
Asthma can be life threatening. If a child is unable to speak in full sentences, confused and weak, and the skin is turning blue or grey, SEEK immediate medical attention, says Dr. Singh.
“A parent should not waste time calling a doctor at this point. Call 911 immediately,” says Dr. Singh.

 For more information or questions contact the Division of Pediatric Pulmonology at 732-565-5467


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