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) if
- 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 > 104°F (40°C)
- 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 If
- 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 Now” symptoms