Parental guidance: Danger of overusing asthma inhalers

Helen O’Callaghan hears about the overuse of reliever inhalers.

If your child has asthma and is using the reliever inhaler more than twice weekly, they need to see their doctor because their asthma isn’t being controlled.

The reliever inhaler (usually blue) is being over-used by asthma patients, says Ruth Morrow, advanced nurse practitioner specialist in Asthma/COPD.

“A child should be on a controller inhaler twice daily – people don’t see how important prevention is. The reliever inhaler should only be used to relieve symptoms,” she explains.

Morrow was speaking following Asthma Awareness Week, when an animated video was launched detailing five vital steps to manage an asthma attack – and essentially, save a life.

This followed survey findings that almost seven out of ten people with asthma don’t know the ‘5 Step Rule’ to manage an attack. Only one in five know the six commonest symptoms of an asthma attack – wheezing, continuous coughing, chest tightness, shallow breathing, lips turning blue and difficulty finishing sentences.

Asthma Society of Ireland CEO Sarah O’Connor says it’s troubling so few people with asthma know the ‘5 Step Rule’. “Knowing the steps to take is essential and could be the difference between life and death. One person now dies every five days from asthma – 90% of these deaths are preventable.”

Five step rule:

- Take two puffs of reliever inhaler, one puff at a time.

- Stay calm. Sit up straight – don’t lie down.

- Take slow steady breaths.

- If there’s no improvement, take one puff of reliever inhaler every minute. Use a spacer if available. Patients over six years can take up to 10 puffs in 10 minutes. Under-sixes can take up to six puffs in 10 minutes.

- Call 112 or 999 if symptoms don’t improve after 10 minutes. Repeat step 4 if the ambulance hasn’t arrived in 10 minutes.

Parents don’t always know what triggers their child’s asthma.

There’s a multitude of triggers. Each child might have one or two – it takes time to identify what they are.

"The first year, it could be colds/viruses but the child can develop others – exercise, pollen, cold air, animal hair,” says Morrow.

Smokers, who smoke outside believing they’ll avoid triggering an asthma attack in children, are mistaken.

“Smoke is on their breath and clothes even four hours after they smoke,” says Morrow. A big trigger at this time of year is grass/tree pollen. “

A high percentage of children with asthma have allergic rhinitis – this makes asthma worse. Students can drop a full grade if suffering from asthma/allergic rhinitis during exams.”

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