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Asthma management in Children
Dr. Ibrahim Salahat  GP

Family Doctors and pediatricians are once again extremely busy this winter as patients with asthma symptoms - the most common disease among children - are lining up in front of emergency rooms and respiratory clinics.

Asthma is a chronic disease affecting the lungs that makes airways (bronchial tubes) particularly sensitive to irritants, narrowing the air passages from the lungs to the nose and mouth (airways), which in turn leads to difficulty in breathing, and this is characterized by difficulty in breathing.  Many factors can lead to asthma, including tobacco smoke, dust, pollen, exercise, viral infections, chemicals in the air or in food, changes in the weather and pests such as cockroaches and mites. When a person experiences a worsening of their asthma symptoms, it is called an asthma episode or, in severe cases, an asthma attack.

There has been a sharp increase in the global prevalence, morbidity, mortality, and economic burden associated with asthma over the last 40 years, particularly in children. Approximately 370 million people worldwide currently have asthma, and its prevalence increases by 50% every decade. In North America, more than 10% of the populations have asthma, while in Chinathere are so many Asthmatic cases which are undiagnosed and undertreated.  Even though after the use of inhaled corticosteroids has made a positive impact on the outcomes of asthma; the mortality rates of asthma (especially among young children) still very high, latest reports suggest that approximately an annually 180,000 deaths in China alone are attributable to asthma

Because the worst seasons for asthma are spring and the change from autumn to winter. Doctors are extremely busy in dealing with asthmatic kids every day at children hospital and respiratory clinics all overBeijing, while at IMC- Beijing we had at least 4-6 cases of kids with asthma every week. It had been noticed that the global number of children with asthma has risen over the past few years. The latest statistics from the China Co-operative Team for Child Asthma Prevention (CCTCAP) show that the incidence of asthma countrywide is around 2 %. CCTCAP has also found out that the major trigger for asthma in china (includingBeijingCity) is a respiratory tract infection, accounting for 94.6 per cent of cases. The remainder is caused by kinds of anaphylaxis (hypersensitivity).

Asthma cannot be cured, but for most patients it can be controlled so that they have only minimal and infrequent symptoms and they can live an active life. The Global Initiative for Asthma has outlined a six-point patient management plan to address the effective handling of the increased number of patients in primary care. The plan focuses on patient education, written treatment plans, ongoing communication and review with patients and their providers. Learning the warning signs can often alert a sufferer in time to take preventive action, such as medication.

An asthma attack is often triggered by exposure to an allergen of some sort – an asthma trigger. Identifying a food or environmental asthma trigger can help to avoid it – and lessen the risk of an acute asthma attack. While there are some people who have food allergies or are especially sensitive to particular things, there are some items that are well-known, common asthma triggers. By controlling the exposure to an asthma trigger, you can reduce the severity and frequency of your child asthma symptoms.

If your child has asthma, managing it is an important part of their life. They should see their doctor regularly. You need to learn what things cause your child's asthma symptoms to worsen and how to avoid them. Your child doctor will also prescribe medicines to keep him/ her asthma under control. Elsewhere, controlling their asthma means staying away from things that bother their airways and taking medicines as directed by the family doctor. By controlling asthma every day, you can prevent your child more serious symptoms and will allow them taking part in all normal activities. If your child asthma is not well controlled, they are likely to have symptoms that can make them misses school and keep them from doing things they enjoy. It's also important to know that managing asthma is not something your child doctor can do for him/ her all by himself. Asthma self help is an important part of treating and managing the asthma condition so that it doesn’t take over their entire life. Your doctor may prescribe both daily medication and medication to take in case of an acute asthma episode, but the task of minimizing risk of asthma attack and taking care of them on a daily basis is largely up to your family. Learning some key asthma self help tricks can help keep your child's asthma under control so that it doesn’t interfere with their daily life. It's also strongly suggested that during the cold winter season, children should wrap up, especially around the neck, when they are outside, in addition, Children with asthma should avoid 'severe' sports, and make good preparations before exercises.

ASTHMA INHALERS AND CHILDREN

The most common method prescribed to treat asthma is giving medication with an inhaler. An inhaler is a small device with a pump that delivers a measured dose of medication when the pump is depressed. In order for the medicine to do its job, it needs to be breathed in before it dissipates in the air. That means that a person using an inhaler needs to be able to breathe in at the same time that the inhaler is depressed. That kind of coordination can be very hard for young children.

That’s why it's important for all children under the age of five be prescribed an inhaler with a spacer and a face mask when they are treated against asthma.  When the inhaler is used with a spacer and a face mask, the medicine stays in the mask so that the child can inhale it all over a few breaths instead of one big breath.

That’s not the only issue that’s made news about children and inhalers. One of the biggest issues facing schoolchildren with asthma, is that those kids must have an access to their inhalers at all times, because after an asthmatic attack, and a high possibility of breathing problem, it's those precious moments that can save some kids life when they have a fast access to their inhalers. That why it is vital that parents of children with asthma insist on their child’s absolute right to carry an asthma inhaler with them at all times, but be sure you know the rules at your child school regarding the keeping of the asthma inhaler.