On the 6th May 2014, the National Review on Asthma Deaths was published; highlighting 1.1 million children in the UK, have asthma. It showed that the UK has one of the worst survival rates for asthma, within Europe. We all commonly hear about asthma and may well have members within our own families, or indeed ourselves, who are diagnosed with it.
In general, we see asthma as a very common, mild condition, which it is in many cases. The report shows that medical professionals are often failing to manage asthma and initiate specialist referrals appropriately- even mild asthmatics can have serious and life-threatening asthma attacks.
What is asthma?
Asthma is a condition in which the airways go into spasm, this narrows the airways and leads to difficulty breathing. The lining of the airways become inflamed and start to swell, the cells of the airways start producing sticky mucus or phlegm, which blocks up the narrowed airways and can make breathing even more difficult.
Image from firstaidforlife.org.uk
What causes asthma?
There is no single one cause of asthma; it is often triggered when someone is exposed to something that irritates the airways.
Triggers that can cause asthma;
Tobacco smoke- children whose parents smoke are more likely to develop asthma
Allergens- pollen, house dust mite, animal fur, feathers
Respiratory infections- coughs and colds
Temperature changes- especially cold air
Stress and emotions
Food and drink that is high in sulphites- concentrated fruit juice, jams, prawns, pre-cooked meals
Irritants- chemicals, pollution
Some medications- ibuprofen, aspirin
If you or your partner has a history of asthma, eczema or allergies, such as hay fever, there is a strong possibility that one of your children could develop asthma.
Symptoms of asthma
Shortness of breath and in extreme cases, may not be able to complete a sentence
Tightness in the chest- like a band tightening around it
Not everyone will get all of these symptoms. Some people experience them from time to time; a few people may experience these symptoms all the time.
There is no cure for asthma, however, there are very effective treatments. They are broadly divided into 2 categories;
1. Relievers- these relieve the symptoms at the time of wheeze. This is usually a blue inhaler, salbutamol.
2. Preventers- these help to prevent future wheezing. These can be tablets or inhalers.
Your GP should be able to assess the treatment that is required from the history that you give them- how often the wheezy episodes occur and when.
The National Review on Asthma Deaths showed that we tend to rely on the blue puffer (reliever) far too much. Blue inhalers should only be needed a maximum of 2 or 3 times a week. If required more frequently, you should go back to your doctor for a review medication.
As a child, and even as an adult, taking an inhaler can be tricky. There are different styles of inhalers for older children, but for younger children using a spacer device has been shown to deliver the medication much more effectively and increases the amount of the medication reaching the airways, rather than hitting the back of the throat. This helps to achieve a much greater control over the asthma.
Image from firstaidforlife.org.uk
Spacers for smaller children are usually fitted with a facemask and for older children, usually just a mouthpiece. You use the spacer device by attaching the inhaler (which needs to have been shaken first to mix the medication inside), squirting in one and taking 10 deep breaths through the spacer. A second puff can then be given and another 10 deep breaths are taken through the spacer are required, and so on.
There are other things that can be done to help prevent asthma from being triggered;
In some cases having the flu vaccination can help by reducing the amount of respiratory infections and hence asthma attacks.
Stopping smoking is a very important way to help anyone who has asthma. Anyone within the household who smokes is bringing small smoke particles into and around the home. These can be enough to trigger a wheezing episode and can lead to an asthma attack. WWW.NHS.UK/SMOKEFREE is a great website if you are considering giving up smoking.
If house dust mite is the trigger, mite-resistant duvets and pillows are widely available. Additionally, removing carpets from the bedroom can help.
How to help in an asthma attack
Be calm and reassuring- reducing the stress and keeping the situation calm really helps.
Panic and fear can increase the severity of an attack.
Children often have a variety of different asthma inhalers and medication to control their asthma – if they are having an asthma attack; it is the reliever inhaler that they need- this is usually the pale blue one.
1. Encourage them to sit upright or stand up as this helps to open up the airways
2. Loosen any tight clothes around their neck and chest
3. Get them to take two puffs of their blue inhaler (see above for how this should be done- one at a time)
4. If they do not start to feel better and their breathing does not ease with another 2 puffs of their inhaler, call 999 and ask for an ambulance. Tell them the child is having an asthma attack so they know to bring specific items to help
5. They should keep taking the reliever inhaler, one puff at a time until their breathing is easier or until the paramedics arrive
For more information about asthma visit http://www.asthma.org.uk/
Dr. Anastasia Alcock
The Prenatal Classroom
Mother-of-two Anastasia Alcock holds a Diploma in Obstetrics and Gynaecology from Imperial College School of Medicine in London. She has worked as a paediatrician in hospitals including Guy’s and St Thomas’ Hospital, London, The Royal Brompton Hospital, London and the John Radcliffe Hospital, Oxford and has significant experience in delivery and newborn care.
Most expectant mums have a multitude of questions as they prepare for their new arrival. Who better to ask for advice and support than an experienced doctor who is also a mum and who above all has the time to listen to your concerns and worries?
Anastasia launched The Prenatal Classroom to offer group and private lessons for expectant parents to teach them the knowledge they need to approach parenthood with confidence.
The course was put together based on Anastasia’s medical knowledge, her own experiences as a mother the psychological wellbeing of pregnant women and with additional input from experts in nutrition, breastfeeding and baby care.
Classes are held in West London and Oxford. They are relaxed and informal but have a clear format and come with the guarantee that the same doctor will teach all your classes.
T: 07940 589 021