Bronchial asthma in children: symptoms, treatment, help with an attack

Bronchial asthma in children , as well as asthmatic bronchitis in a child has the main symptom and symptom: a shortness of breath !Which develops in the presence of 3 pathological components: an allergic edema of the bronchial mucosa;spasm of smooth muscles of the bronchi and increased secretion of mucus, and its thickening.

Here we will talk about the treatment of bronchial asthma in a child and how to give him the first emergency help in an attack.


Causes of

Bronchies of a child with asthma have an increased sensitivity to some external stimuli, which come into contact with the triggering mechanism, and symptoms of bronchial asthma develop. External irritants of the bronchi are allergenic factors.

Allergenic factors can be home dust, dander and animal hair, dry food for fish, pollen of plants, food products, medicines, dust mites, fungi, cockroach antigens.

Asphyxiation can also cause even not allergenic factors of , which include:

  • physical activity,
  • windy weather,
  • ambient temperature drops,
  • air pollution,
  • tobacco smoke,
  • sharp odor,
  • fright, excitement anda neuropsychic agitation.

Separately distinguish "aspirin" asthma, in which the attack occurs after taking aspirin and other non-steroidal anti-inflammatory drugs( NSAIDs).This should be remembered by the parents of asthmatic children and warn them against taking "harmless" aspirin, for example, with fever or headache.

In most children, asthma is often combined with allergic rhinitis, atopic dermatitis, neurodermatitis.

The prevalence and peculiarities of the disease

The peculiarities of modern bronchial asthma are its wide distribution( 9-12 per 1000 children in Russia), an earlier onset( 80-90% of patients with the first attack occurs before 5 years), frequency and weighting of seizures, despitefor a wide range of medicines.

The severity of the disease is determined by the frequency and duration of seizures, the degree of respiratory failure and the effectiveness of medications and procedures. In one child, seizures occur 1-2 times a year and can be easily removed with a single dose of the drug. And another baby's seizures follow one after another, leading to disruption of all metabolic processes and development of disability. Often, the attack leads to severe respiratory problems, requiring the placement of the child in the intensive care unit.

During the course of the disease is given to periods of exacerbation and remission. Exacerbation may occur as an acute attack of suffocation or in the form of a protracted state of bronchial obstruction( impaired bronchial patency).

Seizure: symptoms and signs

The attack begins with with shortness of breath and the appearance of an excruciating cough with hard-to-separate sputum, sometimes resulting in vomiting. There is wheezing, heard from a distance. The child tries to take an elevated position in bed or leans his hands on the chair seat. In case of a severe attack, the mother will notice the incision of the intercostal spaces( "the ribs go about walking").The child becomes restless, "does not find a place", there may appear pallor of the skin and cyanotic lips, indicating a respiratory failure and the need for emergency care.

If the exacerbation occurs in the form of protracted bronchial obstruction, the deterioration develops gradually, and the child coughs for a few days, whistles, but adapts to the violation of breathing and for the time being does not experience special torment.

The suffering of a child during an attack of bronchial asthma can not leave anyone indifferent and require immediate relief.

Treatment of bronchial asthma

Try to at least presumably identify the cause of the attack and eliminate or reduce contact with the allergen.

If the food product or the medicine( aspirin) is "to blame", it is necessary to accelerate its removal from the body: salt laxative, adsorbents, abundant drink.

If pollen of flowering plants is suspected, close the window panes, moisten the air in the room to precipitate dust particles and perform a wet cleaning.

If there are nocturnal seizures, replace the feather and feather pillows on a non-allergenic one, try placing the baby in another room.

Sometimes the mother marks the cessation of attacks when moving to another apartment. For example, they came to visit relatives, and the attacks as a hand took off, and at home every night choked. There is something to think about.

Treatment of a child suffering from bronchial asthma should be comprehensive and lengthy. The purpose of therapy is not only to relieve the acute condition, but also in the after-treatment and off-seizure periods to conduct treatment aimed at preventing exacerbations and lengthening remissions.

First emergency aid in case of an attack of

. In an acute attack, the goal of therapy is to eliminate obstruction of the bronchial tree and suppress the activity of the inflammatory process in the bronchial mucosa. Preference is given to the inhalation route of administration of medicinal substances: ventolin, salgim, berodual, etc. from an aerosol inhaler or through a nebulizer for 5-10 minutes. Coping an attack occurs in a few minutes.

In severe bronchial asthma, aerosols containing corticosteroid hormones - beclamethasone, becotide, pulmicort are used.

The inhaler for individual use with a single press produces one dose of the drug in the form of a fine aerosol that easily penetrates the respiratory tract.

The main task of the patient - to synchronize the pressure of the can and your breath, that is, to do these two actions simultaneously. For a child of early and preschool age, this is practically impossible task. Therefore, for successful inhalation, another device called a spacer is needed. The effect usually comes in 3-5 minutes. If necessary, you can re-inhalation after 5 minutes.

You can not abuse inhalations. These drugs are adrenaline derivatives, and it is not for nothing called the "hormone of fear", and adrenaline overdose causes palpitations, agitation, increased blood pressure, trembling of the limbs, a sense of fear.

During the day, it is not recommended to use the aerosol inhaler more than 4 times.

Inhalation performed by the same drugs will be more effective, but through an apparatus called a nebulizer( from the Latin nebula - "fog").Many parents acquire nebulizers for individual use and with their help easily cope with a child's seizure.


Nebulizer is a device in which a liquid medicine is transformed into an aerosol with the smallest particles that can penetrate into the peripheral bronchi. This is its main, but not the only advantage over an individual aerosol inhaler. The transformation of fluid into a therapeutic "fog" is carried out with the help of a compressor or under the influence of ultrasound.

Another advantage of the nebulizer is that its use eliminates the need for inspiratory synchronization with inhalation. And for a patient during a severe attack it is not easy to combine these two actions in time.

But that's not all.

The continuous supply of medicinal aerosol to the bronchi causes a rapid and significant improvement in the condition, and a simple method of performing inhalations allows the use of a nebulizer at home.

The flow of medicinal particles 2-5 microns in size, emitted under pressure and capable of reaching small bronchi, eliminates spasm all over the bronchial tree.

For children with severe bronchial asthma receiving hormonal drugs, inhaled glucocorticoids are recommended, which are also available as metered-dose inhalers and in plastic containers for use through a nebulizer.

How to help a child without medication

If a child develops an attack of bronchial asthma, but does not have any medication to stop it, call for an ambulance, and before the brigade arrives, give the patient a sublime or sitting position, provide fresh air to the room, offer a warmalkaline drink( mineral hydrocarbonate water, milk, boiled water with a small addition of baking soda).Alkaline drinking helps to separate the sputum.

You can immerse your hands on the elbow in hot water. This technique helps to expand the bronchi.

With the ribs of the hands, beat the patient on the back at the level of the lower corners of the scapula - this massage facilitates the departure of phlegm.

Fortunately, more than half of children who fell ill before age 5, bronchial asthma disappears without a trace at puberty. Hope that your child will be among those lucky ones, and try to do everything that depends on you.

Next, consider a similar topic for the introduction: "What is it - obstructive syndrome in a child?". ..

Obstructive syndrome in children

This diagnosis is increasingly being put to children with respiratory illnesses that are prone to allergic reactions, as against the background of the usualcold or among full health suddenly there is a shortness of breath associated with obstruction of the bronchial tree.

Obstruction - violation of patency - has several causes: edema of the bronchial mucosa, congestion of mucous sputum in the lumen of the bronchi, spasm of bronchial muscles and compression of the bronchi from the outside.

In children, the narrowing of the airway lumen is due mainly to the swelling of the mucous membrane and the accumulation of sputum in the lumen of the bronchi. In older children, a spasm of the musculature of the bronchial tree joins, which is the equivalent of an attack of bronchial asthma.

The disease is characterized by occurrence of an excruciating cough with hard-to-separate sputum, a debilitating baby, interfering with sleep. A loud, wheezing breath is heard, audible at a distance, shortness of breath, which is indicated by the participation of intercostal spaces in the act of breathing. Often, a fit of cough ends with vomiting that contains mucus. After a cough accompanied by sputum or vomiting, there is an improvement in the condition, a decrease in dyspnea, and for some time breathing can become noiseless. But the temporary improvement is again replaced by the increase in dyspnea as a new sputum is accumulated in the bronchial tree.

With increasing respiratory failure, the child needs emergency care to restore bronchial patency.

Inpatient for this purpose, inhalations with bronchodilators are used, capable of eliminating obstruction of the bronchial tree in a short time. At home, this inhalation can not be carried out unless you have a special nebulizer apparatus and a baby mask for it. So do not resist if the doctor insists on hospitalization. Obstructive syndrome exhausts the child, weakens the immune system, depletes the nervous system. Long-term obstruction creates the prerequisites for the development of bronchial asthma.

In a hospital, the child is prescribed physiotherapeutic procedures that remove obstruction and prevent it from occurring in the future: electrophoresis with euphyllin and adrenaline, diadynamic currents, ultraviolet irradiation, etc.

For home treatment, drugs that help to eliminate bronchospasm and improve the separation of sputum, which are convenient for children: clenbuterol syrup and ascaril.

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