Asthma Exacerbation
Your child has been diagnosed with an asthma exacerbation, commonly called an asthma attack.
We know this can be a stressful time with lots of information from healthcare providers. It can be difficult to absorb everything.
We hope the following pages will be helpful in providing you with the education and resources you need to support your child from home.
What is an Asthma Exacerbation?
Asthma is a common, chronic inflammatory condition of the airways.
Asthma exacerbations are most commonly triggered by viral respiratory infections, such as the common cold, influenza, RSV, or coronavirus.
Other potential triggers include allergens, air pollution, seasonal changes, or inconsistent usage of existing steroid puffers.
Click continue to learn more!
Other Resources: Nemours KidsHealth - Asthma
Symptoms of an Asthma Exacerbation
The most common symptoms seen with an asthma exacerbation include:
- cough (usually worse at night or with activity)
- wheezing (high pitched sound when child breathes out)
- chest tightness
- difficulty breathing
Hospital Care
If you have been seen by a medical professional, they may have treated your child with medications. Click below to learn more about these medications.
A. Bronchodilators
Bronchodilators work by relaxing the muscles in the airways,
thereby improving symptoms of asthma such as cough, wheeze,
chest tightness and shortness of breath. Salbutamol (common
brand name: Ventolin, most commonly a blue puffer) is most
often used but may be given with another medication called
ipratropium bromide (common brand name: Atrovent).
During an asthma exacerbation, bronchodilators are usually
given using an MDI (puffer) with a spacer or using a
nebulizer with the goal of quickly improving symptoms.
B. Steroids
Steroids act to reduce inflammation. In asthma, steroids
reduce inflammation in the airways to help improve symptoms.
They typically take a few hours to start to work but last
over 24 hours. Therefore, it helps provide longer-lasting
relief. Commonly prescribed steroids used for an asthma
exacerbation include prednisone and dexamethasone.
Not every child requires steroids to treat an asthma
exacerbation. If your child was prescribed this medication,
please follow the instructions of the doctor and if you have
any questions, speak to your doctor or pharmacist.
C. Oxygen
If your child is having difficulty breathing or low oxygen levels, your medical team may give them supplemental oxygen. Oxygen is usually delivered by face mask or nasal prongs. Generally, if a child requires oxygen, then they may need to be admitted to hospital for further care.
What to do at home
Click below for information on ways to help at home.
Avoid triggers
Common triggers for asthma include:
- Environmental irritants such as smoke, pollution, and strong odours
- Airborne allergens such as pollen, mold, dust mites, and pet dander
- Respiratory infections such as the common cold and flu
- Physical activity or exercise
- Very cold and dry air
- Emotional stress or anxiety
Getting vaccines for the flu and COVID will reduce illness severity and the severity of asthma attacks.
Quick-relief puffer
Also called "rescue" or "reliever" puffers, they act fast to
help open the airways. Generally, it is advised to use for
symptoms of cough, wheeze, or shortness of breath.
The most common puffer prescribed is a blue puffer called
Ventolin (salbutamol). Please use as directed by your
physician.
Controller medications
These are daily medications used to reduce airway
inflammation. For example, inhaled corticosteroids such as
fluticasone or beclomethasone, or non-steroidal medications
like montelukast.
Please use as directed by your physician. Not using these
types of medications as directed can lead to more frequent
asthma attacks.
Spacer and mask
This device increases the amount of medication that gets to your child's lungs, making the inhalers more effective. Here is a 1-minute clip on how to use the spacer with the inhaler: Steps to Using an Inhaler with a Spacer and Mask
Help manage viral illnesses
If viral infections are suspected triggers for your child's asthma, you may find the following link helpful as well: Paediatrics@home - Viral URTI
When to seek medical attention
Here are some signs that, if present, should lead you to seek immediate medical attention:
- fast or laboured breathing (skin or muscles around your child's ribs are pulling in with each breath)
- cyanosis (blue lips or tongue)
- lethargic or non-responding child
- quick-relief medication does not seem to be relieving symptoms
Follow Up
Please follow up with your primary care provider unless instructed otherwise. Of course, if you feel your child needs immediate medical attention, please do not hesitate to call 911 or bring them to your closest emergency department.
We hope this has been useful. Thank you for using Paediatrics@home!