I Know How to Use a Stethoscope, or, Having a Child With Asthma or Reactive Airway Disease

When a child has breathing issues, it’s scary. Unfortunately, my children have been to the emergency room and admitted to the hospital more times than I care to think about. Thankfully, they are both doing rather well now. Here are some things I have learned along the way about having a child with asthma or reactive airway disease. (Remember that I am not a doctor or nurse so, please, always consult with your child’s pediatrician regarding your child!)

♦  Asthma or Reactive Airway Disease? Breathing problems in children under 6 are usually not diagnosed as “asthma” because they cannot accurately gauge whether it is actually asthma until they are older.  They often call it reactive airway disease in babies, toddlers and preschoolers. It can refer to wheezing, fast breathing and labored breathing, all of which can be serious.

♦  Triggers: In young kids, breathing issues are usually triggered by colds, viruses and other common illness. Some people think that allergens, like pollen, are the only thing that triggers wheezing, but in small children, wheezing is more often caused by colds and viruses.

♦  Warning Signs: Know what signs and symptoms to look for which may indicate breathing trouble. In general, you want to watch for the following: fast breathing, labored breathing where the chest and neck are showing unusual visible movement inward with each breath (called retraction), flared nostrils, coughing a lot, wheezing, grunting when exhaling, or a bluish color around the mouth. If you see these symptoms, call your child’s doctor, go to the emergency room, or call 911!

♦  Caretakers: Make sure all caretakers, including day care providers, teachers, grandparents, and babysitters, know what to watch for and what to do if your child shows any of those symptoms. Create a list of emergency contacts and outline of what to do in case your child shows any symptoms of breathing problems.

♦  Stethoscope: If your child often wheezes, ask a doctor or nurse to teach you how to use a stethoscope to listen for wheezing. You can buy them inexpensively. During one of my son’s hospitalizations, a great nurse gave me a stethoscope to take home and taught me how to use it. It was, and still is, so helpful to listen to my kids’ chests to see if they are wheezing, and if the nebulizer treatments are helping the wheezing. It takes some practice to use it and learn what you’re hearing. But if you have a kid who wheezes, having a real stethoscope and knowing how to use it can provide a lot of peace of mind.

♦  Breathing Rate: Check with your pediatrician as to how many breaths per minute is too high. With our first child, there were several times I was up at night counting my son’s breathing rate to make sure it was not in the danger zone, and sometimes we had to go to the emergency room. It is helpful to know what rate to watch for ahead of time.

♦  Pediatrician: It’s great to have a doctor who can be reached by phone around the clock. An office with someone on call after hours, including in the middle of the night, is very helpful and may save you a trip to the ER with just a phone call.

♦  Hospitalizations: If your child is hospitalized for breathing issues (or for anything, really) keep track of what medications they give your child, when doses were given, and for what purpose. Ask lots of questions. If you don’t feel comfortable with the course of treatment proposed, ask why it needs to be done, if there are alternatives, and the pros and cons of each. In my experience, there’s so much going on, so many people involved, and you are the only adult present the entire time. You can provide a narrative and chronology of what’s been happening and your child’s progress. Also, you know your child best and can gauge how they are feeling better than anyone. I’m not suggesting that the medical staff will be anything less than competent, but you are your child’s ambassador and can help things go smoothly if you pay attention to what’s going on. During our first ER visit, the nurse asked me a question about something that I wasn’t keeping track of due to my stressed out state. It made me realize that I could provide some value, and needed to pay more attention to the details of the treatment. Since then, during our other hospital visits, I’ve been asked many times if I was a doctor or nurse because I provided a lot of relevant information. The medical staff said it was helpful, and they gave me more info when I was paying attention and asking intelligent questions. Maybe some of them secretly did not like that I asked about everything, but you know what? I do what needs to be done to make sure my child is well cared for, and learn more about his condition. As Ben Franklin said, an ounce of prevention is worth a pound of cure!

I hope what I have shared helps. Do you have any tips or information to share, or want to comment on this post?  Please leave a reply below.  Thanks for reading!