Don't use this guideline unless your child was previously diagnosed as having asthma,
asthmatic bronchitis or reactive airway disease by a physician.
The classic symptom is a wheeze or whistling (purring) sound on breathing out.
See More Appropriate Topic
If no previous asthma diagnosis or use of asthma medicines, see WHEEZING
Call 911 Now (your child may need an ambulance)
Severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing,
making grunting noises with each breath)
Your child passed out or has bluish lips/tongue
Wheezing started suddenly after medicine, an allergic food or bee sting
Call Your Doctor Now (night or day) If
Your child looks or acts very sick
Looks like he did when hospitalized before with asthma
Difficulty breathing not resolved 20 minutes after neb or inhaler
Peak flow rate < 50% of baseline level (personal best)
Peak flow rate 50-80% of baseline level after using neb or inhaler
Wheezing (heard across the room) not resolved 20 minutes after using neb or inhaler
Continuous (nonstop) coughing that keeps from playing or sleeping and not improved after using neb or inhaler
Asthma medicine (neb or inhaler) is needed more frequently than every 4 hours
Fever > 104oF (40oC)
Severe chest pain
Call Your Doctor Within 24 Hours (between 9 and 4) If
You think your child needs to be seen
Lots of yellow or green nasal discharge now with a fever
Sinus pressure or pain
Fever present > 3 days
Call Your Doctor During Weekday Office Hours If
You have other questions or concerns
Missing > 1 day of school/month for asthma
Asthma limits exercise or sports
Asthma attacks frequently awaken from sleep
Uses more than 1 inhaler/month
Mild wheezing persists > 5 days
No asthma check-up in > 1 year
Parent Care at Home
Mild asthma attack and you don’t think your child needs to be seen
Home Care Advice for Asthma Attack
Asthma Medicine:
Start the inhaler, nebs or oral asthma medicine at the first sign of any coughing or
shortness of breath (don't wait for wheezing).
The best "cough medicine" for a child with asthma is always the asthma medicine.
Continue the asthma medicine until your child has not wheezed or coughed for 48 hours.
It takes a minimum of 7 days of medicine for lung function to return to normal.
Hay Fever: For nose allergy symptoms, it's OK to give antihistamines.
Fluids: Encourage a normal intake of clear fluids (e.g. water).
(Reason: normal fluid intake keeps the lung mucus from becoming sticky.)
Humidifier: Humidifier: If the air is dry, use a humidifier (Reason: to prevent drying of the upper airway.)
Avoid or Remove Allergens: Give a shower to remove pollens, animal dander, or other allergens from the body and hair.
Avoid known triggers of asthma attacks (e.g., tobacco smoke, feather pillows, exercise).
Expected Course: If treatment is started early, most asthma attacks are quickly brought under control.
All wheezing should be gone by 5 days.
Call Your Doctor If
Inhaled asthma medicine (neb or inhaler) is needed more often than every 4 hours
Wheezing is not completely cleared by 5 days
Your child becomes worse or develops any of the “Call Your Doctor” symptoms
