Childhood illnesses

Asthmatic attacks in children. Interview with Dr. Olga Cortés


In Spain, one in five asthmatic children misses six or more days of school due to illness and approximately 3 percent of all minors between the ages of 9 and 12 have visited the emergency services for an asthma attack.

Furthermore, in recent years, the number of 6-year-old children with this pathology has increased. The pediatrician Olga Cortés, of the Respiratory Tract Group (GVR) of the Spanish Association of Primary Care Pediatrics (AEPap) teaches us to control an asthmatic attack.

How should parents and children react to an asthmatic crisis?
The most important thing is to react early. The first is knowing how to recognize the symptoms that are causing an asthma attack, and the second is to start treatment as soon as possible. First, the airflow obstruction must be reversed to decrease hypoxemia, which is the decrease in oxygen in the blood. This is the most dangerous because it decreases oxygen in important organs such as the heart or the brain. To reverse the airflow obstruction, there are two drugs that we use in the treatment of asthma attacks which are rescue drugs, short-acting beta-2-adrenergic bronchodilators, and oral corticosteroids.

How is the treatment for an asthmatic attack?
First you have to recognize an asthma attack: he coughs a lot, has fatigue, wheezing, tightness in the chest. That I have to do? I have to act immediately, I can't wait. I start with the rescue treatment. If it does not improve, I must go immediately to the ER.

Can asthmatic attacks in children be prevented?
There are nonspecific stimuli such as tobacco, which should be avoided in asthmatic children. You should not smoke in the home of an asthmatic child. You should also avoid other types of fumes that are also irritating, for example, in the kitchen we have extractors and many times we do not put them. Avoid paints, chemical cleaning products and everything that can be irritating to the airways.

What else can be irritating to the airways?

For example, all allergy-specific allergy tests, such as pollens. Avoid going to fields or gardens when they are in peak pollination period. If we are talking about a sensitization to mites, it is necessary to avoid that the child's room has many stuffed animals, curtains or carpets, because dust and mites accumulate there. If we are talking about fungi, try that the home is dry, that there are no damp spots on ceilings or walls and that there are no humidifiers.

What about pets?
If we talk about pets, the ideal when you have a dog or a cat and the child is sensitized is for the animal to leave the family home, but this is sometimes impossible because they have become fond of the animal and do not want to take it out. So, what you have to do is wash the animal every week so that it does not shed a lot of hair, remove rugs or carpets where the animal's hair and dander accumulate, which is what gives the child an allergy.

Does the alteration of emotional states also trigger an asthma attack in children?
Yes it's correct. Emotions that provoke bodily reactions such as laughing or crying can trigger an asthma attack or can make an existing attack worse. It is a non-specific stimulus of bronchospasm, airflow decreases and the asthma attack appears.

Is atopic dermatitis an asthma trigger?
It is an important risk factor in young children under 3 years of age who have recurrent bronchospasm and recurrent wheezing attacks.

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