When to go to the ER
This is always a tough one. It sounds so drastic to take someone to the emergency room. And let's face it, kids with asthma seem like they're sick ALL of the time, especially when they are little.
So, when do any of you take your kids to the ER versus the doctors office or treating them at home?
I'm comfortable doing treatments every 4 hours on the nebulizer when the kids are sick, but as Asthma Doc says, "That's just a Bandaid approach. You've got to find out what's causing the inflammation." I always take the kids to Asthma Doc to start, he knows them so well, he knows how they respond (or don't respond to medication). Often times, we have to do a round of steroids (Prednisone bottles are always part of our medicine chest). Sometimes antibiotics if they have pneumonia.
But how do you know if you need to go back? What about after-hours doctor visits or skip that altogether and head to the ER? Webmd has a great section on their website called What is an Asthma Attack? It lists symptoms of an asthma attack and tells you when to call 911,
This is what I have learned over the last 11 years, but don't take my word for it-ask your doctor what he wants you to watch for!
The kids may:
- look pale
- have dark lips
- be listless
- breathing very quickly-actually "panting". (That's what "asthma" means by the way-it's the Greek word for panting)
- unable to speak in complete sentences
- can't stop coughing
- medicine doesn't seem to be working.
Their skin may be pale or slightly gray. They may also have dark lips or fingernails. Some people say "blue lips or fingernails", but I have never seen that with my kids. Their lips will be VERY dark, it will almost look like they are wearing dark red lipstick. Couple that with the pale skin, and they LOOK terrible. (think vampire from the Twilight movies-minus the sparkly skin).
The other sign that is very serious is called "retraction" which simply means that they are using all of their muscles to breath. So the skin is "retracting" or sucking in around the rib cage, often times you can "count ribs" because the skin even sucks in between the ribs. Also watch the collar bone and the little "U" shaped bone just under the Adam's apple. The skin will suck in along that area too.
Sometimes the nostrils will flare out because they are struggling to breath.
If you see those symptoms, head to the Emergency Room - FAST! Or call an ambulance. When you get there, make sure they understand your child has asthma and breathing difficulties. My kids get seen before someone who needs stitches or who broke their arm. There is a reason they have triage-they take people in order of medical condition, not who got there first.
Speak up if you feel your child is getting worse, you do not want your child to pass out and have their airway collapse. Remember, 11 people die every day from asthma attacks. And they all think it's going to happen to "someone else"
So, I don't mean to scare anyone, but I have seen some scary situations with my own kids-they can go from bad to worse very quickly.
Talk to your doctor, see what he recommends and know what to watch for. You can do this! And if you feel like you are in over your head, go to the Emergency Room. That's what insurance is for, and that's what the doctors are trained to do. Take care of your kids.