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Biological, psychological and social complexities in childhood development
Biological, psychological and social complexities in childhood development

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1.3 Acute episodes of asthma

As you will have seen from Activity 3 in the previous section, recognising when a child is having an asthma attack is important; failure to seek medical attention at the right time could be life-threatening. Acute episodes can be caused by a range of factors but are typically related to exposure to a trigger or allergen such as infections, pollen, dust, pet dander, smoke, chemical fumes or strong odours. Children who are experiencing an asthma attack typically present with shortness of breath, chest tightness, wheezing and/or coughing.

Activity 4 Acute asthma episodes – child and parent perspectives

Timing: Allow 30 minutes

Listen to the following audio of a parent talking about what it is like to have a child with severe asthma who is hospitalised, then watch the animation created by Chloe, an 11-year-old girl, talking about what it feels like to have an asthma attack.

You should make notes about the process that is followed when a child is having an asthma attack and think carefully about how the parent and child might feel during these episodes.

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Video 2 What it feels like to have an asthma attack
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Chloe, who produced this animation, is 11 years old and has had asthma for several years. She wakes up during the night at least once per week and wheezes over three times per week, so this could be considered uncontrolled asthma. Her peak flow can be variable but is usually around 115. The National Institute for Health and Care Excellence (2020) recommends that there should be a self-management plan in place for people with asthma.

If you were caring for the child as a healthcare professional, what actions could you take to support both the child and parent when they are admitted to hospital? Think about the things they might be thinking and feeling.

In Table 1, make some notes about the things you should be thinking about and the care you should provide. For example, what communication strategies would you use? Why?

Table 1 Aspects of care needed for Chloe and parents
Aspect of care needed/action Rationale: how would this help the parent/child?
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Discussion

You might have identified many different care needs that Chloe and parents may feel are important. Effective communication, such as active listening and distraction techniques, could be useful skills for you to use as a healthcare professional. Chloe and Chloe’s mother have identified the following areas of priority.

Chloe says:

It’s important to be reassured by the nurses when having an attack, as you do feel very scared, very panicked and confused and need someone to be calm and to make you calm. A calm person to be there to talk to you, to reassure you that everything is going to be ok, that you are safe now. Then to explain exactly what is going to happen next, step by step and why they are going to do it.

For Chloe, distraction is very important – to be distracted by the nurse with stories or a joke or two, or even an iPad with games or a book. Anything to take the mind away from what’s happening.

She highlights the importance of being kept informed of what’s going on and what might happen next. Will I go onto a ward? How long will I be there for? What happens next? Will this happen again? What can I do to help prevent it happening again?

It would helpful to be given a booklet to take away for information about attacks and medication, or be directed to a website for further information.

Chloe’s Mum says:

Advice on when to call an ambulance. When Chloe had her asthma attacks back to back within the school, at first the teachers didn’t have a clue how to deal with them as they hadn’t been trained so they panicked. As Chloe continued to get them, they decided to send all staff – the teachers, helpers and dinner ladies – for asthma training. Could this be compulsory for all schools? Maybe nurses could go into schools to train staff and to give talks on the subject to raise awareness? It would help the other children to understand what is going on; Chloe got teased a bit for using her inhaler in the class by the boys!

One of the most important things is effective communication, care and compassion for those involved. Communication strategies might take the form of verbal or non-verbal communication, e.g. active listening or the use of touch. Parents will likely feel very anxious and scared for their child, so you may have included some strategies for supporting them; sometimes this is as simple as providing a hot drink, allowing them to stay with their child or providing reassurance.