How to identify that your child is having an asthmatic attack?

Asthma is one of the common diseases in children. Studies say that asthma is the number one reason for poor attendance in schools. Most children get asthma (wheezing) due to allergies, and not because of any pathologic causes. Hence, asthma in children resolves by its own or can be overcome by avoiding those causitive factors.

Asthma is an intermittent, reversible, obstructive airway disease. It affects both children and adults. There are about 6 million children affected with this chronic disorder. Asthma can be life threatening when not treated properly. Death due to asthma is rare in children. It generally affects the normal day to day life activities and is the third leading cause of hospitalization during childhood.

Asthma in children are caused by allergens like animal dander, pollen, dust, food, and mold. If the child suffers asthma due to any of the above mentioned allergens, then it is called allergic asthma. The children with this type of asthma will definitely have a family history of allergies. Exposure to any such allergens triggers an asthmatic attack. Children with allergic asthma will usually overcome the condition by adolescence.

Asthma may not be related to specific allergens in children. Certain factors like common cold, respiratory tract infection, environmental pollutants, chemicals, food preservatives, exercise, play, and emotions can trigger an attack. This type of asthma is called as idiopathic or non-allergic asthma.

Some children develop a mixed kind of asthma which is the most common form of asthma. It has characteristics of both allergic and nonallergic asthma. Cigarette smoke, exposure to cold air and irritating gases, and viral infections are some of the common stimulants of asthma in children.

Asthma being an airway obstructive disease, it is caused by one or more of the following reasons:
1. Contraction of muscles surrounding the bronchi, which narrows the airway;
2. Swelling of membranes that line the bronchi; and
3. Filling of the bronchi with thick mucus.
The exact mechanism of these changes is not known, but most of what is known involves the immunologic system and the autonomic nervous system.

The three common symptoms of asthma are dyspnea, cough, and wheezing. An asthmatic attack starts at night, with a cough and a tight sensation in the chest, followed by slow labored, and wheezy breathing. The child assumes an upright position and uses all the accessory muscles of respiration. The obstructed airflow causes dyspnea. The cough is tight and dry at first, later it loosens and produces thin mucus containing small, round, gelatinous masses.

Chest x-ray taken during the acute attack shows hyperinflation and a flattened diaphragm which confirms the diagnosis. Sputum and blood studies disclose eosinophilia and an elevation in immunoglobulin E. Bronchodilators and anti-inflammatory drugs are helpful in treating asthma in children. Bronchodilators like epinephrine, terbutaline and ipravent are given in the form of inhalation during an active episode.

Chromolyn sodium, a mast cell inhibitor prevents anaphylaxis, thereby resulting in bronchodilation and a decrease in airway inflammation. This is more helpful between attacks or when asthma is in remission. Corticosteroids reduces inflammation and swelling, and is given in the form of intravenous injection.

The only way to prevent asthma attacks in children is to identify the allergen and avoid them. Seeking treatment at the initial stages of asthma will prevent the progress of the disease. Asthma becomes fatal with age because the number of deaths increases with age.