• Reference Number: HEY-377/2016
• Departments: Paediatrics
• Last Updated: 25 February 2016

Introduction

This leaflet has been produced to give you general information about your child’s asthma.  Most of your questions should be answered by this leaflet.  However it is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.   If after reading this you have any concerns or require further explanation, please discuss this with a member of the healthcare team who has been caring for your child.

What is a management plan?

A management plan provides information on how and when your child’s inhaled treatment should be given. The management plan also provides information that would be useful to follow if your child is unwell.

What are the treatments?

The majority of young children who develop wheezing episodes in the first year of life remain generally well and stop having wheezing episodes when they are four to five years old. This is not true asthma.

However some young children do go on to develop asthma and this is more likely if there is a family history of atopy (asthma, hay fever and eczema). There are two groups of inhaled treatments that your child may require.

These are referred to as:

• reliever inhaler
• preventer inhaler

Reliever treatment – should only be given with symptoms such as breathlessness, coughing and wheezing.

Preventer treatment – if a preventer inhaler is started for your child it should be given every day and only stopped by your child’s doctor or specialist nurse.

Can there be any complications or risks?

If your child remains unwell at home in spite of having regular inhaler reliever treatment, this may indicate that your child’s condition is deteriorating and you should seek medical help. If your child’s inhaled treatment is not given through a designated delivery device, the inhaled treatment will not be as effective. If you have concerns regarding any potential side effects of treatment prescribed you should discuss this with your child’s doctor.

Management Plan

Name _______________________

Date of Birth ________________________

Date of Issue ___________________

Reliever Treatment

Treatment	Inhaler	Colour	Dose	Frequency
Salbutamol	Aerosol inhaler	Blue	2-10 puffs	As required or directed at discharge
Salbutamol	Salbutamol	Salbutamol	Salbutamol	Salbutamol

Please continue with 2-10 puffs of the reliever inhaler regularly following discharge from hospital for two to three days or until your child’s symptoms stop. Then only use the reliever inhaler when required. Please note if there is no immediate improvement in your child’s symptoms following 2 puffs of the reliever inhaler (giving one puff at a time) when needed continue to give up to ten puffs. Remember if 10 puffs of reliever inhaler has been required this is an emergency treatment. Please see emergency treatment box. *

Reference: Asthma UK (2011) Asthma in the under fives (asthma.org.uk)

Acute Asthma Attacks

In children, colds are usually responsible for acute attacks. These result in cough, wheeze and breathlessness.

What immediate action should you take?

With mild attacks reliever medication should be given every two to three hours. If symptoms settle no further action is necessary.

What if the symptoms do not settle?

If symptoms do not settle give reliever treatment as pre emergency management plan (for example – up to 10 doses of the blue inhaler with 30 seconds between).

* Emergency Treatment Box

Treatment	Inhaler	Colour	Dose	Frequency
Salbutamol	Aerosol	Blue	10 puffs	Emergency

If there is not a good response to this or response is for a short duration you should telephone your doctor straight away. If your doctor is unavailable to visit immediately dial 999 for an ambulance or take your child to the accident and emergency department and continue to give treatment.

Controlling Asthma

Asthma is well controlled if:

• There is no cough or wheeze at night which disturbs sleep
• Participation in activities is normal
• Use of reliever inhaler is minimal

If control remains good for several months, it might be appropriate to reduce the amount of preventer medicine. This can be discussed with your child’s doctor or specialist nurse.

Discharge from hospital

Before your child leaves hospital you will be asked to sign a discharge form to show you have received enough information about your child and that you understand it. The information that you receive should be both verbal and written information and about your child’s condition.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats your child, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to your child. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your child’s condition, the alternatives available for your child, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about your child

We collect and use your child’s information to provide your child with care and treatment. As part of your child’s care, information about your child will be shared between members of a healthcare team, some of whom you may not meet. Your child’s information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide your child with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your child’s doctor, or the person caring for your child.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about your child. For further information visit the following page: Confidential Information about You.

If you need information about your child’s (or a child you care for) health and wellbeing and their care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.