Ataque de Asma
Call 911 Now
- Wheezing and life-threatening allergic reaction to similar substance in the past
- Start to wheeze suddenly after a bee sting, taking medicine, or eating an allergic food
- Severe trouble breathing (struggling for each breath, can barely speak or cry)
- Passed out (fainted)
- Lips or face are bluish when not coughing
- You think your child has a life-threatening emergency
Go to ER Now
- Looks like he did when hospitalized before with asthma
- Trouble breathing not gone 20 minutes after neb or inhaler
- Peak flow rate less than 50% of normal rate (Red Zone)
- Ribs are pulling in with each breath (called retractions)
- Pulse oxygen level less than 90% during asthma attack
Call Doctor or Seek Care Now
- Lips or face have turned bluish during coughing
- PEFR is 50-80% of normal rate after using nebulizer or inhaler (Yellow Zone)
- Wheezing not gone 20 minutes after using neb or inhaler
- Breathing is much faster than normal
- Nonstop coughing not better after using nebulizer or inhaler
- Severe chest pain
- Need to use asthma medicine (neb or inhaler) more often than every 4 hours
- Fever higher than 104° F (40° C)
- Your child looks or acts very sick
- You think your child needs to be seen, and the problem is urgent
Contact Doctor Within 24 Hours
- Mild wheezing lasts more than 24 hours on neb or inhaler treatments
- Sinus pain (not just congestion)
- Fever lasts more than 3 days
- Fever returns after being gone more than 24 hours
- You think your child needs to be seen, but the problem is not urgent
Contact Doctor During Office Hours
- Don't have written asthma action plan from your doctor
- Use an inhaler, but don't have a spacer
- Miss more than 1 day of school per month for asthma
- Asthma limits exercise, sports or other activities
- Asthma attacks wake child up from sleep
- Use more than 1 inhaler per month
- No asthma check-up in more than 1 year
- You have other questions or concerns
Self Care at Home
Care Advice for Asthma Attack
A spacer (or holding chamber) can be useful for all people with asthma. A spacer makes it easier to correctly inhale the asthma medicine from the metered dose inhaler (MDI). A spacer is very useful in younger children and older adults.
- STEP 1 - Shake the inhaler and then attach it to the spacer (holding chamber).
- STEP 2 - Breathe out completely.
- STEP 3 - Place the mouthpiece of the spacer in your mouth.
- STEP 4 - Press down on the inhaler. This will put one puff of the medicine in the holding chamber or spacer.
- STEP 5 - Breathe in slowly for 5 seconds.
- STEP 6 - Hold your breath for 10 seconds and then exhale.
- If your doctor has prescribed two or more puffs, wait 1 minute between each puff and then repeat steps 1-6.
Dry powder inhalers require a different inhaling technique than regular metered dose inhalers (MDI). To use a dry powder inhaler, it is important to close your mouth tightly around the mouthpiece of the inhaler and to inhale rapidly. Here are the steps:
- STEP 1 - Remove the cap and follow package instructions to load a dose of medicine.
- STEP 2 - Breathe out completely.
- STEP 3 - Put the mouthpiece of the inhaler in the mouth.
- STEP 4 - Breathe in quickly and deeply.
- STEP 5 - Hold your breath for ten seconds to allow the medicine to reach deeply into your lungs.
- If your doctor has prescribed two or more inhalations, wait 1 minute and then repeat steps 2-5.
Every adult with asthma should have a peak flow meter. A peak flow meter measures how well air moves out of your lungs. The number that is obtained is called the peak expiratory flow rate (PEFR). The "personal best" value is the highest PEFR number that a person obtains when they are feeling well.
Here is how to use a peak flow meter:
- STEP 1 - Move the indicator to the bottom of the numbered scale. Stand up.
- STEP 2 - Take a deep breath, filling your lungs completely.
- STEP 3 - Place the mouthpiece in your mouth and close your lips around it. Do not put your tongue inside the hole.
- STEP 4 - Blow out as hard and fast as you can.
- STEP 5 - Repeat the process two more times.
- STEP 6 - Write down the highest of the three numbers.
Using a Peak Flow Meter to Determine the Severity of an Asthma Attack:
- GREEN Zone - MILD Attack: PEFR 80-100% of personal best
- YELLOW Zone - MODERATE Attack: PEFR 50-80%
- RED Zone - SEVERE Attack: PEFR less than 50%
A metered dose inhaler (MDI) is a device used to deliver asthma medicine into the lungs. To be sure to deliver the medicine effectively, use the following steps:
- STEP 1 - Remove the cap and shake the inhaler.
- STEP 2 - Hold the inhaler about 1-2 inches in front of the mouth. Breathe out - completely.
- STEP 3 - Press down on the inhaler to release the medicine as you start to breathe in slowly.
- STEP 4 - Breathe in slowly for three to five seconds.
- STEP 5 - Hold your breath for ten seconds to allow the medicine to reach deeply into your lungs.
- If your doctor has prescribed two puffs, wait 1 minute and then repeat steps 2-5.
Copyright 2000-2024. Schmitt Pediatric Guidelines LLC.
Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.