When to Go to the ER if Your Child Has Asthma

One of the main goals of parents whose kids have asthma is avoiding trips to the emergency room (ER) for breathing problems. But it's also important to know when going to the ER is the right choice.

You'll be better prepared to make that decision if you discuss it with your child's doctor before your child has a severe flare-up. The doctor's instructions should be included in your child's asthma action plan, which also will list peak flow meter readings or specific symptoms that are your cue to go to the ER. If old enough, your child also should know what these signs are.

When to Seek Help

Some general signs that indicate you should seek help very quickly by getting to the doctor (or if the doctor isn't available, going to the ER or calling an ambulance) include:

• if there are changes in your child's color, like bluish or gray lips and fingernails
• if your child is having trouble talking
• if the areas below the ribs, between the ribs, and in the neck visibly pull in during inhalation (called retractions)
• if your child uses rescue medications repeatedly for severe flare-up symptoms that don't go away after 5 or 10 minutes or return again quickly
• if your child's peak flow reading falls below 50% and doesn't improve with medication

Making ER Trips Less Stressful

Advance planning can make trips to the ER less stressful for you and your child. Here are some ways to make it a little easier:

• Know the location of your closest emergency room. If there's a children's hospital ER nearby, go there and have the address and phone number readily accessible (it can be written on your child's action plan).
• If you have other kids, try to make arrangements with a relative or other caregiver who can take them in an emergency situation. But don't let the lack of a babysitter delay your trip to the ER. Someone can always come to the hospital later to pick up your other children.
• Take a copy of your child's asthma action plan or a note with the names and dosages of any medications your child takes to share with the medical staff at the ER.

Following Your Child's Asthma Action Plan

Well-managed asthma is rarely life threatening. People who have died from asthma usually haven't taken their medications as prescribed and have a history of repeated severe asthma flare-ups and emergency care. If you and your child take asthma seriously and work to manage it, you can reduce the chances that your child will need to go to the emergency room.

It's important to monitor your child's asthma using the written asthma action plan your doctor helps you create. This plan will outline your child's day-to-day treatment, list symptoms to watch for, and give detailed, step-by-step instructions to follow when your child has a flare-up.

Some key points of a plan are:

Avoiding Triggers

The doctor should be able to help you identify the triggers that can cause asthma flare-ups. These may include animals, dust mites, mold, tobacco smoke, cold air, exercise, and infections.

Taking the Controller Medications

Your child should take his or her controller medications as prescribed by the doctor, even when feeling fine. Skipping doses can cause the lungs to become more inflamed, which can lead to a decrease in lung function. (This can happen without your child even experiencing any symptoms.) It also puts your child at risk for more frequent and severe flare-ups.