nebulisers for children

Just wondered when are nebulisers brought into the daily amanagement plan for children?

My daughter (16mths) has had asthma for nearly a yr and is on Ventolin, seretide and Montelukast. Her consultant has swayed whether to prescribe a nebuliser for home but then changes his mind as he feels she should be in hospital if that bad to need one.

Recently our GP has mentioned that she may need one and that I should look into buying one.

Im confused! Would you say she should have one or not? What do other children with Chronic Asthma do?

At present she has pred once a month due to flare ups or chest infections. She's recently had pleuresy too. She doesnt always wheeze with her Asthma which is just another story!!!!

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  • Hi we have the same prob no wheeze, nightmare!!I think the consultant is worried that you may leave it too late to get your daughter seen if you have a nebuliser at home.My Sons asthma changes at such a quick and huge rate we were given one at first to use while we waited for an ambulance.We have a plan that if my Son needs his neb we can use it but need to see someone if it doesn't hold for 4 hours. Even then we have to see a doctor at the first available chance. We can then nebulise every 4 hours up to 4 times in 24 hours, if that doesn't work we have to go in to hospital (by this point my Son asks for oxygen so we have to go in)Mattys had his nebuliser since he was 2. We bought a portable one when he was 3 (had to replace in December £235 but worth every penny) the one given by the hospital is kept at school. It is a risk having a home neb as things get out of hand very quickly and you can get a false sense of security. You always need to be on your guard. I check my Sons breathing as its such a give away all is not well, no wheeze is such a problem, just wish he would.

    I hope your Daughter feels better soon, It's so much harder when they are small.

    take care

    Kate x

  • Completely agree no wheeze is a nightmare. My son very rarely wheezes when in an asthma attack and when he does it is very hard to hear. But thankfully his class teacher after having lots of training from my hubbie who is a TTA (Training Teaching assistant) at my son's school know can pin-point when Ryan ois having an attack and medicates acordingly but if she not 100% certain she will sit him in the quiet area and ask one of the other children to go and get Ryan's dad from which ever class he is in on that particular day for advice and guidance on what to do. We used ot have a nebuliser but a few years back we were told to give it back as Ryan hadn't had to use it for all most 2 years because we had his asthma perfectly controlled and we were able to manage it dueing bad periods with out the nebuliser but know I wish we had it again. I am starting a nebulisere fund pot so that we can buy a portable nebuliser but in the mean time if me and Ryan require a nebuliser we go tot he doctors or call for an ambulance

  • Thank you for your replies.

    Can i ask how bad your childs asthma was before needing a neb? How often were they having problems and in what way?

    My daughter is generaly ok-ish during the day when not under the weather with a chest inf etc. At night however, she coughs for England and is often very sick repeatedly. We have to get her up for at least an hour in order to clear the mucus from her chest before she can then lie back down to sleep!

    If she has a chest infection or even a simple cold, these symptoms can be alot worse and more often.

    The montelukast seems to be doing wonders though as she has fewer flare ups since on it. Just wondering if she really is bad enough to warrant one or are we jumping the gun?

    Alot of people are shocked as to how bad she is but to us I guess we are getting used to it! Therefore im at a loss to how bad she is or needs to be before we go down the home neb path.

    When would we use it??

    Would it help the nighttime attacks??

    When she's having a coughing fit, she fights the spacer so therefore its harder to administer the meds. Would a neb be easier for this??

    Sorry for all the questions. Have got an appointment with the Asthma nurse on Monday and want to be prepared!

    Many thanks

    emily.

  • My Ryan was just under 2 when we where given the nebuliser because between the age of birth - 18 months he only had a grand total of 4 month sat home the rest of it he was in hospital with his asthma. They refused to diagnose him asthma until he was 18 months due to the fact that he went into distress udeing labout and they believed the micome had coursed soem damage to his lungs even though they sucked his airways out and for 2 day swas giving him oxegen treatment. He also spent most of those 18 months suffering repeated infections. But at the age 6 they took the neb away as we where controllin gthe asthma by following 3 different asthma action plans. We still have 3 different action plans 1 controlled asthma healthy, 2 common virus and night coughing and 3 infection control which is th eplan we ar eat present as I believe he has a chest infection again.

    I perdsonally would hold off getting a nebuliser as I found that Ryan fighted more with the nebuliser than he did with the spacer. Which spacer do you have? Just wondering as there are 2 different makes of sapcers and I have found that the bets one I have used with Rayn is a small light-weight spacer that has teddy bears on it. Sorry name has worn off the spacer but it isn't the one that looks like bubble it is just a think tube with a built in mouth piece. Ryan is know starting ot learn how to take his inhaler with out the spacer with him being older and we do breathing exercisers with hi twice a day and we have taught him that if he listens to his body and stops as soon as he starts to feel strange as he calls the very early signs of an attack then he can prevent the attack happening and avoids using the inhaler unless it is truely needed. It is so hard seein ghtem stugle especially at such an young age. I can still remember how I felt seeing Ryan having attacks at 16 months. I always blamed myself as he inherited his asthma from me and they way we had to administor his meds was also so hard. I woul dhave to sit with him inbetween my legs with my legs wrapped around him and then with one arm hold him against me with the arm crossed over his chest and running up his neck so I could hold his head and then with my other hand use that the spray on control the spacer while holding the inhaler in place ready to spray his next puff. All while talking and trying ot hide that I wa sstressed out because he was struggling to breathe. After an attack he would have a sleep and while he was sleeping that is when I would cry and get myself back together after dealing with him.

    I was always tod that he could out-grow his asthma by the time or with-in a year of turning 5 but we are know almost 3 years over 5 and no improvement if anythign it is worse all I can say is I hope for you that this is just infant asthma and I pray your little girl's asthma improves over time to the point were she no onger needs the meds. But one other thing I can say is over time you will find you start coping better with the whole ordeal and the attacks don't seem to be a sscarey for eithe rof you. It's like they become part of normal life and routine and it's like well that's another attack dealt with until the next one never mind we can have fun and deal with it when they happen as it's life and all part of the joys of being a mum to such a precious treasure

  • Asthma family - thank you sooooo much for your reply. yes, your absolutely right about it all being a part of life when its in the family. My husband has severe asthma and is on pred most of the winter months. He wheezes so its easier i guess. I can hear him wheeze before he enters a room sometimes! Madness!

    Your technique for administering inhalers sounds similar to mine. I have to put her in a bear hug on my knee while holding the spacer to her face. She often hits the spacer to the side and it flies onto the floor!

    We have the huge volumatic spacer as we were told that was the more efficient for getting the drugs to the lungs as the vaccuum effect was more forceful with each breath. We also have the small tube ones for sticking in my bag if we go out anywhere but dont rely on these day to day.

    We have no action plan as such for different scinarios at the minute so will definately ask the nurse on Monday about this. We have a general plan as to how much drugs we give before calling the ambulance.

    Alot of my daughters problem is the mucus on her lungs and trying to clear it. We are waiting to have another chest xray to examine her chest again for any underlying causes. At first they queried CF nut as my husband is clear, then my daughter wouldnt have it. The trouble is we havent had a clear few days in order for her to have the xray as they want it while her lungs are ok!

    Huh, the Asthma malarky is sooooo debilitating. I wish more people understood just how scary it is.

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