Monthly Archives: May 2013

  • Calming Asthma In Children

    calming asthmatic childAsthma is a frightening and debilitating disease in adults. It can be terrifying; shortness of breath, wheezing, coughing, tightness in the chest and so on. So imagine how much more frightening it is for a child.

    As an adult you can rationalise, you can fight the fear and calm yourself down, relax and allow the symptoms to subside. Children can suffer terribly with asthma, and they rely heavily on parents to provide the safety net and calm that they aren’t yet mature enough to provide for themselves.

    So as the parent of a child with asthma, are you ready? Do you recognise the signs? Do you know what to do during an attack? Are you aware of what triggers you should avoid and how to find out what they are? Do you have the right medicines and equipment on hand to deal with an attack, and most importantly, do you have a plan for when you should seek professional medical help?

    Knowing The Problem

    Asthma is a common so-called “chronic inflammatory disease of the airways” featuring recurring symptoms, including but not limited to wheezing, coughing, chest tightness, and shortness of breath.

    The disease can be very difficult to diagnose in children, partly due to the lack of feedback that children can give about exactly how they feel and where they feel it. Many pediatricians are reluctant to diagnose asthma in especially young children, partly due to the fact that children under 6 who experience what is termed “reactive airways disease” do not go on to develop full blown asthma, even if the disease as treated responds to asthma medication.

    Most commonly asthma is treated with corticosteroids, usually administered with an inhaler. Other medicines are prescribed for asthma but this is the one you will encounter the most. If your child has other allergies such as hay fever or is sensitive to other allergens, you will possibly be using other medications in addition to the inhaler. All cases are different and you should seek guidance from your doctor about dosages and application of medicines.

    Once a diagnosis of asthma has been established, the responsible parent will always be ready for action. Firstly you have to do something you will find very easy: know your child. There are risks with young children that if they get a lot of attention because of some ailment, there can be a tendency on the behalf of the child to use ill health to gain attention on demand. You have to be sensitive to that and know when your child is either seeking attention or genuinely in distress. Most parents know the difference.

    You should also consult your doctor on ways to discover the triggers that might be causing your child’s asthma, and take steps to avoid those triggers. It may be that you could improve the quality of your child’s life by merely purchasing a vacuum cleaner that filters out allergens. Your doctor will have concrete advice on household environments that relates directly to your child.

    Signs and Symptoms

    That established, you have to have a plan of action. The signs of an asthma attack vary wildly between children, but you will learn those that regularly apply to your child. There are different stages of severity and different ways to manage each stage.

    Not all children have the same symptoms, and they can even vary from attack to attack in the same child, so be aware and flexible too. Possible signs and symptoms can include:

    Frequent coughing spells, during play, at night, or while laughing or crying; chronic cough (which can sometimes be the only symptom); less energy during play; intermittent rapid breathing; chest tightness or chest "hurting", shortness of breath and most obviously the whistling sound of restricted airways that we commonly call wheezing.

    You may also notice see-saw motions (called retractions) in the chest from labored breathing. This is very noticeable and alarming, but as always, calmness is one of the best tools you can use to soothe your child during an attack. Look also for tightened neck and chest muscles, or perceived weakness or tiredness.

    What To Do

    Number 1: be calm. You child is already panicking by the time you get to them or they wouldn’t have called you. You need to be an oasis of calm and something they can focus on and anchor to. This helps immensely, and your child will draw a lot of strength from your calm and positive support.

    Number 2: check for the signs above. It’s possible if your child has a corticosteroid inhaler and knows how to use it, that it has been used already. Ask your child if they used their inhaler. Maybe they panicked and forgot, although if the child has suffered from asthma for a while this will be automatic. If the inhaler has been used already coach the child to take slow steady breaths. Panic attacks also cause shortness of breath, and it could be that the fear of an attack has caused a panic attack. Speak calmly and slowly and breathe along with your child. Slow and steady.

    Number 3: if the child doesn’t start to breathe more easily, then start “two for two”, two puffs on the inhaler every two minutes. Do this up to 10 times.

    Number 4: if after the two for two you feel after some time that your child is not improving or even getting worse you should call 911.

    In most cases, although frightening and difficult to remain calm, attacks will subside with this coaching and calm. Your child should calm down, the attack should pass and they should be relaxed and breathing more easily. It’s hard sometimes to keep your calm demeanor in the face of your child’s distress, but you must remain absolutely rock solid calm and keep a positive attitude. Say to yourself with conviction “This will subside."

    If it doesn’t ,then you calmly move to the next phase, and call 911. Assistance will arrive, and if it takes longer than about 10 minutes you can return to the two for twos for another 10 puffs or until they arrive.

    What Should You Have On Hand?

    At all times you need to have any inhalers that your child has been prescribed, and monitor the inhalers so you notice when they are getting empty. Make sure you have backups if possible. It is common for asthma sufferers to take multiple medications for their allergies, and these also need to be filled when empty. If your child uses a nebulizer or other kind of vaporizer, it needs to be in working order and used as prescribed.

    Also of key importance are knowledge and a plan. You and your child should know the disease as it affects you personally, symptoms and treatments that apply to you, and most important of all have a plan.

    Asthma Action Plan Stages

    Many people have an action plan as a chart that is printed out and placed somewhere prominently in the house. It is usually organized as zones.

    Green Zone: Doing Well

    No cough, wheeze, chest tightness, or shortness of breath; can do all usual activities. Take prescribed long term control medicine such as inhaled corticosteroids.

    Yellow Zone: Getting Worse

    Cough, wheeze, chest tightness, or shortness of breath; waking at night; can do some, but not all, usual activities. Add quick-relief medicine.

    Red Zone: Medical Alert!

    Very short of breath; quick-relief medicines don't help; cannot do usual activities; symptoms no better after 24 hours in Yellow Zone. Get medical help NOW.

    Living And Thriving

    Whatever your experience of asthma with your child, you can prepare for attacks and manage them calmly and effectively if you are aware of the disease and can explain it to your child. If you and your child are knowledgeable and aware you can, together, deal with it calmly and positively. You can help your child not only survive but thrive.

    Further Reading

    Examples of full action plans can be found at the CDC web site:

    Statistics about Asthma

  • Make An Asthma Action Plan

    One of the most effective tools for you to use when managing your child’s asthma is to be prepared. Although outwardly calm during an attack you may actually be panicking yourself, so a written down plan can be literally a lifesaver. It makes the situation seem organised and safe from the perspective of the child and provides you with an easy to remember method of dealing with attacks. A well-written action plan can make you and your child feel in control of the attack and that is one of the most precious things you can have in these situations.

  • Asthma Support And Information Podcasts

    If reading reams of paper or screen text is making your head hurt, perhaps you can absorb useful information through listening to these Center for Disease Control podcasts about asthma. The CDC has all the facts and you can get tips and strategies for managing your child’s illness just by listening to Internet radio broadcasts. Many other podcasts exist, including these from the Medical University of South Carolina. Just search for "asthma podcast" on the web.

  • Asthma Condition And Treatment

    Will your child outgrow asthma, and can it be cured? The American Academy of Asthma, Allergy and Immunology has some authoritative answers to these and many other questions. Although asthma is a chronic condition, asthma-like symptoms can present in very young children and can be treated. They will in all likelihood grow stronger and the symptoms will subside. Full asthma has no cure but it can be mitigated with treatment and knowledgeable management.

  • Guide To Asthma

    The symptoms of asthma can vary not only between children but also from time to time in the same child, so it’s wise to be aware of all the possible symptoms.

    WebMD has a brilliant article about all the possible symptoms and also the possible causes of your child’s asthma. Know the illness well and you can be calm and help your child to be calm too. Information is your most valuable tool in managing and controlling the disease.

  • How to Breathe Easy – Managing Asthma in Children

    asthmatic childThis week our subject is asthma in children. How can parents help manage the symptoms and minimise the distress and suffering which the disease can cause? Asthma is a common so-called “chronic inflammatory disease of the airways” featuring recurring symptoms, including wheezing, coughing, chest tightness, difficulty speaking and shortness of breath.

    But curiously the symptoms of asthma can vary not only from child to child but also from attack to attack in the same child. You should be aware of the range of symptoms that your child might experience and how to deal with an asthma attack, and we will be talking about this all this week.

    The most frequently asked question is this: Can asthma be cured or outgrown? Well, asthma has no cure, as yet, but it may be that depending on the age of your child that they have some other infection that is presenting asthma like symptoms. If in doubt see your doctor, be well informed and know the difference.

    Information is crucial, but there is a large amount of information on the web. How can you find it, and what other sources of information exist? How about podcasts or newsletters? Have you got an action plan? What should it contain to make attacks seem more organised and safe for both you and your child?

    The most important thing is to remain calm at all times, and the best tool to help you remain calm is being fully informed and ready for what may happen during an attack. If you know what to do and have steps to follow you can be the most help to your child during an asthma attack, and at least feel a little more in control of the situation.

    This is our theme for this week, childhood asthma and how to deal with it. We'll answer all the above questions to help you make the right choices and minimize the distress and fear your child may experience from this terrifying disease.

  • Memorial Day

    Today, May 27 is Memorial Day. This federal holiday allows us to pay tribute to Americans who've died in military service. In their honor, please observe a moment of remembrance at 3:00 p.m. local time on May 27.

    Find Memorial Day information and resources, including:

    • Veterans' stories
    • Patriotic songs
    • Barbecue and food safety tips
    • Ways to support our troops and our nation
    • Swimming and boating safety
  • Battlefield Healthcare For Heroes

    Battle FieldIt’s been a fascinating week, looking into the lives and work of the combat medics. It’s a complicated and hazardous job, and the soldiers who do it are highly trained and they go where they are needed. It sounds like an obvious and simple thing, but getting the medics to where they are needed quickly is a huge logistical undertaking. For example how far is “as far forward” as possible? Too close to the action and you put the medics in danger of injury themselves before they have a chance to do any good. Too far back and they arrive too late. It’s an exact science and one that needs to work well for the health and safety of our troops.

    Combat medics are not doctors. They are more akin to battle ready EMTs. They provide emergency medical treatment out on the battlefield, but they also personally manage the evacuation (or EVAC in military speak) of the patients from the point of injury to temporary hospital accommodation further from the operating front of the battle. Most combat medics have a specialism in addition to their basic training, like dialysis or occupational therapy, for when they are working the mobile hospitals.

    Combat medics are highly trained professional soldiers as this is more useful than training doctors and nurses to effective in combat. Combat medics need to be aware and sensitive to both the medical and military considerations of the environment and the circustances of the injuries. They are battle ready paramedics skilled in securing and stabilising patients for EVAC and handing them off to mobile hospitals for their continued care.

    Combat medics have adapted and grown to match the circumstances in which they find themselves, and lessons learned in the theatres of war have been incorporated in the training to make better medics. Training is crucial to save lives, both the patients and the medics.

    The Air Force also has its own medics, called the Pararescuemen or PJs who have are airlifted to where they need to be, pick up wounded soldiers, and return with the wounded for treatment. But being airborne they have the additional challenge of being a new target in any battlefront, and so they have avoid being shot down before they can rescue anyone.

    As Memorial Day approaches, remember that not all those who serve their country carry weapons. Some carry bandages, hypodermics, and medicines, and they save lives rather than kill. But they too have seen their share of war, and are often faced with more death and injury than anyone else in the theater of combat. Every injured veteran who returns home does so because a medic was there and did their job.

    They, too, are American heroes.

  • Part Warrior Part Medic All Hero

    Finally this week, here's this amazing documentary from National Geographic which follows the lives and work of the Pararescuemen or PJs as they perform their duties for the US Air Force in Kandahar, Afghanistan. The film gives a glimpse into the lives of the airmen whose job it is to rescue injured soldiers from the front lines all over the country and take them to secure locations for treatment. If you’ve ever wondered what it’s really like on the front line being a combat medic, then this is an unflinching eye on the world of heroes, and the other less obvious heroes who rescue them to fight another day.

  • Evolving The Perfect Combat Medic

    As with anything to do with warfare, you have to adapt to evolving circumstances. The modern combat medic, says the Department of Defense, has evolved alongside events and is now unrecognisable compared to the original soldiers who were trained by nurses in the first and second World Wars. The training they receive is about making them able to save lives but it needs to be “battle-focused” training. It’s relatively easy to treat a simple but painful wound in a nice quiet hospital ER, but it's a whole different matter doing the same job under fire. Not only is the patient vulnerable to additional injury while immobile, but the combat medic is putting their life on the line to treat them. Training saves lives, especially battle-ready training perfectly executed under duress.

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