Asthma is a common childhood condition. Estimates are that around 8 percent of all children have it. The incidence had been steadily increasing for many years, but some recent data suggest the burden of the disease in children may have leveled off over the past couple of years. That’s encouraging, but the number of children with asthma is still huge. The peak age group is 5 to 14. The best way to think of asthma is that of an exaggerated reaction of the small airways in the lungs to common irritants, making them constrict and reduce airflow. These include viral infections, environmental triggers, and poorly understood things intrinsic to the individual. There is a strong familial tendency to developing asthma. Additionally, some things predispose to it, including sedentary lifestyle and obesity.
Over the past decade, there has been an increasing push to recognize that asthma is multifactorial and that early interventions, things parents can do at home if their child’s symptoms worsen, can head off acute deteriorations that lead to hospitalization. The standard now is that every child with asthma have an action plan for the family to follow. The plans are designed to be specific to the child and concrete in their instructions about what to do. They typically divide into three, color-coded sections. Here’s an example of what they look like:
There is some research showing how useful these plans can be. The investigators looked at 3,510 children with asthma treated over the years at Primary Children’s Hospital in Utah. The notion was to see if increased compliance with asthma control measures by the family would reduce the number of hospital admissions. That turned out to be the case, significantly so. Interestingly, one of the biggest problems for the research project was to get physicians to accept and go along with the best current evidence-based information about how to manage asthma. I’m actually not surprised by this. Asthma management has changed over the years, and current best practice is not what I was taught years ago. Things change, but many physicians don’t.
The key for any parent who has a child with asthma is to have a clear understanding of exactly what to do if your child has worse breathing problems. Many visits to the hospital could be headed off if all parents had such a plan, as well as a resource person to call if the plan is not working.
Christopher Johnson is a pediatric intensive care physician and author of Keeping Your Kids Out of the Emergency Room: A Guide to Childhood Injuries and Illnesses, Your Critically Ill Child: Life and Death Choices Parents Must Face, How to Talk to Your Child’s Doctor: A Handbook for Parents, and How Your Child Heals: An Inside Look At Common Childhood Ailments. He blogs at his self-titled site, Christopher Johnson, MD.
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