ASTHMA AND EXERCISE-INDUCED BRONCHOSPASM (EIB) |
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DESCRIPTIONAsthma and exercise-induced bronchospasm is a chronic breathing disorder characterized by recurrent attacks of wheezing and shortness of breath. It affects many children and adults who exercise regularly.
Appropriate health care includes:
Emergency-room care and hospitalization for severe attacks.
Psychotherapy or counseling, if asthma is stress-related.
SIGNS & SYMPTOMS
Chest tightness and shortness of breath.
Wheezing when exhaling.
Coughing, especially at night, with little sputum.
Rapid, shallow breathing that is easier when the child sits up.
Breathing difficulty--neck muscles tighten.
Severe late symptoms: (Call your doctor. This is an emergency!)
Bluish skin.
Exhaustion.
Grunting respiration.
Inability to speak.
Mental changes, including restlessness, confusion, or delirium.
CAUSES
Spasm of air passages (bronchi and bronchioles) followed by swelling of the passages and thickening of lung secretions (sputum). This decreases or closes off air to the child's lungs.
RISK FACTORS
Allergens, such as some medications, pollen, dust, animal dander, molds, and some foods; air irritants, such as smoke, smog, and odors; exercise, especially exercise in smoggy or cold air (bronchospasm can occur within minutes while exercising in cool air -- warm, humid air seldom triggers exercise-induced bronchospasm); lung infections such as bronchitis; stress; family history of asthma or allergies; smoking; use of drugs to which your child is allergic, such as aspirin.
PREVENTING COMPLICATIONS OR RECURRENCE
Instructions for your child: Avoid known allergens and air pollutants. Take prescribed preventive medicines regularly -- don't omit them when you feel well. Reduce activity level (sometimes). Exercise indoors on smoggy or cold days.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory blood studies and pulmonary-function test; chest X-rays.
POSSIBLE COMPLICATIONS
Enlarged chest from repeated asthma attacks over a long period of time.
Pneumothorax (collapsed lung).
Repeated lung infections.
COPD (See Glossary) from recurrent attacks.
Respiratory failure.
PROBABLE OUTCOME
Your child's symptoms can be controlled with treatment and strict adherence to preventive measures. Children often outgrow asthma. Without treatment, severe attacks can be fatal.
TREATMENT
HOME CARE
Eliminate allergens and irritants from your child's environment at school, at home, and at work, if possible.
Urge the child to carry regular medications at all times. Ask your doctor about having emergency drugs available.
Teach the child to sit upright during attacks.
Train the child to practice deep breathing and postural drainage (See Glossary) each morning to loosen accumulated lung secretions.
MEDICATION
Your doctor may prescribe:
Expectorants to loosen sputum.
Bronchodilators to open the child's air passages.
Corticosteroid drugs by nebulizer (fewer adverse reactions than oral forms).
Cromolyn sodium by nebulizer. This is a preventive drug.
ACTIVITY
Instructions for your child:
Stay active, but avoid sudden bursts of exercise. If an attack follows heavy exercise, sit and rest. Sip warm water.
Continue sports activities if your symptoms can be controlled. If not, decrease exercise levels temporarily until symptoms improve.
DIET & FLUIDS
No special diet, but your child should avoid foods to which he is sensitive. Urge the child to drink at least 3 quarts of liquid daily to keep lung secretions thin and loose.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has frequent symptoms of asthma.
Your child has an asthma attack that doesn't respond to treatment. This is an emergency!
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