Care of Children & Teenagers with Asthma
The Lead GP for this is Dr A Vance and the Lead Asthma Nurse is Lisa Snowden
Stay on top of your child’s asthma symptoms
An asthma review is an appointment with your child’s asthma nurse to check their asthma is as well managed as possible. It’s a chance for you, your child and the asthma nurse to talk about your child’s asthma and any ways you can manage their symptoms better. Your child should have an asthma review at least once every six months.
4 reasons why your child needs regular asthma reviews
A review is an important way for you to stay on top of your child’s asthma. Taking your child for their regular review can help you…
- Manage their symptoms better
Milder symptoms like occasional coughing and wheezing may not seem serious. But they can get in the way of your child doing some of the things they enjoy, like playing with their friends or taking part in sports. Children with asthma don’t need to put up with coughing and wheezing.
At their review, you can discover how small tweaks – like a tiny change to the way they use their inhaler - can make a big difference. If their symptoms get worse or they even end up having an asthma attack, you might look back and wish you’d taken them to their review. Don’t risk that happening.
- Keep them symptom-free
If your child doesn’t have any asthma symptom, that’s great – you’re doing a good job of managing their asthma. But a review can help to keep them symptom-free in the future. Asthma symptoms can come and go, and your child’s asthma can change over time, especially as they get older. At their review, the asthma nurse may carry out some simple tests to find out how well they really are – remember that children aren’t always able to explain how they’re feeling. Your asthma nurse will also make sure they’re on the right dose of medicine to keep their symptoms at bay, so they can carry on doing the things they want to do.
- Feel more confident
A review can help you and the rest of your family feel confident your child’s asthma is well managed. That can be especially important if your child’s recently started school, they’re going away on a school trip or they’re having a sleepover for the first time. Knowing that your child’s asthma is checked regularly, and that they’re getting the most benefits from their medicine, can give you great peace of mind.
- Get your child into good habits
One day, your child will have to manage their asthma on their own. So it’s a good idea to make sure they’re used to going to regular asthma reviews and talking to the asthma nurse about their asthma. If they’re old enough, you could involve them with the review and encourage them to ask a few questions. This will help them – and you - feel more confident they’ll be able to manage their own asthma when the time comes.
What to expect from your child’s asthma review
Your child’s asthma nurse will:
- Ask about your child’s asthma symptoms. For example, are they:
- disturbing their sleep?
- affecting their normal daily activities, such as school or sport?
- causing them to use their reliever inhaler (usually blue) more than two times a week?
- Check your child’s inhalers and make sure they’re on the right treatment and dose. They might reduce or increase the amount of medicine your child takes.
- Check your child’s inhaler technique. Even a little tweak can help ensure as much of the medicine as possible ends up in your child’s lungs, where it’s needed.
- Discuss and update your child’s written asthma action plan with you. This is a personalised plan containing the information you need to look after your child’s asthma well.
- Answer any questions or concerns you have.
Your child’s asthma nurse may:
- Check your child’s peak flow. The peak expiratory flow test, or PEF, measures how fast they can breathe out. It can show how open your child’s airways are. This depends on age and need.
Before your review
If you and your child take a bit of time to prepare for the review, you’re likely to get what you need from it.
- You might find it helpful to keep a symptom and peak flow diary for a month before your child’s review. This will give you and the asthma nurse a clear picture. Every day, you and your child could write down anything you think might be a symptom – you’ll be able to discuss whether it’s linked to your child’s asthma and what you can do about it. Also note down whether they’ve taken their medicine as prescribed and any triggers you spot.
What to take with you to your child’s review – your checklist
- Your child’s written asthma action plan to update – or a new one to fill in, if you don’t already have one for your child
- Your child’s inhalers and spacer, so their asthma nurse can check their inhaler technique
- The list of questions you’ve prepared, and a pen and notepad in case you want to make notes
At your child’s review, make sure you:
- Talk about any concerns you have about your child’s symptoms or their medicine. Make sure your child has a chance to talk about anything that’s bothering them, too. Even if the worry seems small, don’t be afraid to bring it up. It’s important you go away feeling reassured. Your asthma nurse will want to put your mind at rest.
- Are honest if you’re finding it difficult to manage your child’s asthma. For example, if you have found it hard to get into a routine with your child’s preventer inhaler, or you’re not sure you’re using the spacer and inhaler properly, tell your asthma nurse. They’ve spoken to lots of parents about these sorts of difficulties and will want to find a way to help you manage your child’s asthma better.
- Understand everything your asthma nurse says. Ask questions to be sure you are clear. Don’t worry that you’re being a nuisance – it’s important you leave feeling sure what to do to manage your child’s symptoms.
Don’t leave your child’s review without:
- An updated written asthma action plan.
- Answers to your questions and concerns.
- Knowing what medicines they need to take and why.
- Feeling confident they’re using their inhaler(s) and spacer in the right way.
- Booking their next review, if possible – and making a note of it in your diary.
The other times your child should see their asthma nurse
- Their symptoms are getting worse
- They’re using their blue reliever inhaler more than three times a week
- They’re waking at night because of asthma
- They’re not able to carry out their usual daily activities
- They’ve missed school because of asthma
- They have had an asthma attack but haven’t needed to go to hospital
These may all be signs your child’s asthma has got worse. They may even be at risk of having a potentially life-threatening asthma attack. So don’t risk looking back and wishing you’d got help in time.
Within two working days if:
- They’ve had to go to hospital with an asthma attack.
- Their inhalers are running out.
Within a month if:
- They’ve started a new medicine.
- Their medicine has been changed or adjusted.
After 12 weeks if:
- They’ve had no symptoms and haven’t used their reliever inhaler – the asthma nurse may decide to reduce their medicine (stepping down)
According to seasonal triggers if:
- Your child gets hay fever - go the month before it usually starts. Managing hay fever is an important way of managing your asthma and can help ensure they don’t miss school and exams during the summer term.
- You want to talk about whether your child should have a flu jab in the autumn.
At any time if:
- You have any concerns about your child’s asthma – for example, you have questions about their medicines or you’re worried their inhaler device is no longer the right one for them.