urgent advice needed

My 3 year old has a cough and is slightly wheezy - his respiratory rate while asleep is 30 while awake about 36 - he has had three episodes of viral induced wheeze, in dec, jan and feb - 2 overnight hospital stays. I'm not sure how much Salbutamol to administer - in the past i've felt it necessary to give the maximum 10 puffs - which the hospital said was the right amount - however as its not as bad this time - what is a better amount to give him - please can someone advise me as soon as possible - any advice is greatly appreciated.

thankyou in advance x

15 Replies

  • snowgirl is a pead staff nurse, you could try private mailing her.

    What dose is the inhaler? Multidosing (10puffs) is only a quick fix and not a real solution as I'm sure you know.

    I'm sure I dont need to tell you but asthma can kill and you cant be too carefull with your children, I would urge you to ring NHS24 and get advice, it might result in your child needing an A & E review but its always better to be safe than sorry, nip it in the bud and recovery will be so much quicker for him.

    Meantime, double his 'normal' dose and see if that helps but please seek medical advice MY ADVICE IS NOT IN ANY WAY FROM A MEDICAL PROFFESSIONAL PERSPECTIVE. I am a nurse and a brittle asthmatic, my asthma nurse says multi dosing is not a treatment but a 'rescue remedy' only to be used once or twice as a last resort. If I have to multidose she insists I contact her or out if hours NHS24/Direct

    hope this helps, please keep us posted.

  • As jr99 below says, the best thing to do is ring out of hours doctor service and ask for advice if you feel it's urgent, or see your GP asap. Asthma varies from person to person and we can't give medical advice on this forum (indeed, we're not allowed to). It sounds like you should take your son to get checked out and to explain your concerns/get some more guidance. Good luck and I hope things improve for your little boy.

  • How is the little boy? Its so hard I realise now its a learning process to know what to do. But the advice given is excellent advice.

  • hey

    like bee-there says i am a childrens staff nurse yes, and am mre than happy to give you advice, anytime :)

    but if its urgent dont delay, ring out of hours just incase i am not online, or even moreso urgent - ring 999

    hope he is doing okay :)

    snowygirl :)

    x x x

  • hi

    Thanks everyone for all your advice - in the end i had to use mother intuition - i decided that by 10pm it was worse so he had a maximum 10 puffs as previously advised by the hospital - by 2am no better so we went into A&E - he was kept in and discharged yesterday - 4 times in 4 months and although there is a family history of asthma and allergies - no asthma diagnosis - he's much better - although he will be spending alot of time indoors and running around (hyperactivity).

    Thanks for all your replies. x

  • Hi - in reply to your post

    Hello, was just wondering if your son has been prescribed a brown (steroid) inhaler. My daughter has been in hospital several times with a viral induced wheeze (asthma still not confirmed) but since starting on the brown inhaler last November her symptoms (touch wood) have greatly improved and she even managed to get through the cold winter without any GP visits.


  • normally with several viral wheezy episodes, the docs where i used to work used to start kids on montelukast? if they thought could be allergy component

    that could be another option.

    bu certainly the brown inhaler (becotide/beclomethasone) will help. by taking it twice a day it helps by keeping the airways open sp hopefully reducing the amount of times you need to give your son the blue inhaler.



  • hi

    Hi everyone,

    He was prescribed the brown inhaler (becotide - 100mg) a month ago - one puff twice a day - after this last visit they have increased it to 2 puffs twice a day. I'm hoping it will help but after 4 hospital admissions in 4 months I'm not so sure. They have also recommendedn that my GP refers him to a respiratory clinic - this could take several months. Don't know if there is anything i can do to prevent another attack as we dont know whats causing it - i'm thinking it is exercise induced as he likes to run about and often ends up with a flushed face. He started nursery in Jan - and then we've had 3 hospital admissions since then. They have advised me it is an OFsted requirement he gets 30 mins outdoor play - i'm wondering if he is overdoing it outdoors as he is quite boisterous.

    Although weve been through this 4 times now, i am no closer in knowing why its happening and what i can do to prevent it. I'm hoping the respiratory clinic will shed some light or be able to do further tests.

  • hi

    glad to hear they have at least put him on a preventer inhaler as that should help reduce some of his symptoms.

    they can do skin testing -allergy tesing, to see if he has allergy testing? that could test some light maybe?

    also, if you think it is exercise induced asthma, with his symptoms etc indicating towards such, taking his blue inh before and after playtime may help? maybe mention that to your asthma nurse.

    hopefully u wont be waiting too long for the referral, especially due to his age, and u will have more of ur questions answered :)


  • Hi,

    I haven't been on this site for quite a while, registered a few years ago and found the site really helpful. Just lately my son's asthma has taken a downward turn and at the moment we do not seem to be away from the doctor's.

    Currently he has been home nebulised, 10 day course of steroids and x2 antibiotics (aswell as his usual asthma meds, purple & blue puffer & singulair plus ofcourse Calpol for his extremely high temperature!!)

    Today we have had to take him back to the doctor's and he is on yet another course of antibiotic (and steroids should we feel he needs them but to try and hold off if we can??) and this time the doctor advised upto 25 puffs of his blue puffer every 4 hours (apparently that would equate to the same dosage as a nebuliser).....and ofcourse if that is not helping then up to A&E........

    I just wanted to write this because I think it helps me to deal with this (feel such a scardy cat although I do not show my son (I do keep calm)).....

    My fingers are crossed for you all on here and I hope we all start to feel better real soon

    Take care All

    Serenity xx

  • hi serenity

    i am glad it makes you feel better just by writing it down :)

    NB: giving your son 25 puffs every 4 hours is too much and certainly doesnt equate to a neb, even for an adult... did you mean to write 25 or 5??

    if i want to give myself a neb in inhalers, i give myself 10 puffs. so for a child it would mean 5 puffs every 4 hours or whenever needed.

    in summary:

    adult - 1 neb = 10 puffs

    child - 1 neb = 5 puffs so, please check this....

    x x

  • Hi Snowygirl,

    Thank you for your reply. I too have always understood that 10 puffs of blue inhaler was max dose, but after seeing gp today and asking whether he would be better on a nebuliser than inhaler the gp said that his inhaler is just as good because the home nebulisers are not oxygen driven like they are in hospital (which apparently is better?(

    My son was on 2.5ml salbutamol nebs every 4 hours and the gp worked out that up to 25 puffs every 4 hours was the same as having 4 hourly nebs (ofcourse my mind has probably got information overload!!)

    I have also resorted to the steroids (couldn't hold off any longer) as I know the signs (but then again its not great to be back on steroids but.........)

    Here's hoping for a good night (can't wait for the morning to be here)

    Take care

    Serenity xx

  • hi serenity

    maybe you should ring nhs direct for advise or out-of-hours gp or even a+e!!

    especially if you have started pred as well. 25 puffs is way too much...

    are the puffs working?

    2.5mg neb is 5 puffs yes

    5mg neb is 10 puffs yes

    inhaler just as good as neb though, research proven, if given via spacer.

    hope it is not such a long a nite as u think, and the morning comes quickly for you and he improves. let us know how he is doing :)

    x x

  • Hi Snowygirl,

    Thanks again for your advice.

    We got through the night but his cough is pretty bad and he did need his inhaler (via spacer) through the night, and still neeeding it now.

    He does have a consultant at our hospital (has six monthly check ups), so I don't know if its worth calling the consultant's secretary for advice and see if he can be seen earlier. I think he has a nasty bug that is not responding to antibiotics (he is now on Amoxoclav, has been on Klaricid and his usual Amoxicillin - forgive spellings!!), perhaps he needs to have a throat swab taken?

    I am very glad to see the morning, strange that you feel slightly more confident in the day time, prob because the gp's etc are open!! Just feel so helpless, and my son being my son still wants to do things, I don't think he really appreciates how ill he is (even his gp says to other medical people ""he is like this whatever - full of energy - apart from ofcourse when he is in the middle of an attack!)

    I hope you have a good day and thank you for listening to me and your advice.


  • hi serenity.

    no need to thank me for advice, thats what we here for :)

    glad you made it okay through morning, true though we do always feel more confident by day!

    yes see if you can bring appt further, maybe he needs his meds tweeked a little....

    not sure bout the throat swab or sputum samples etc.. as he already on antibiotics. although on the other hand i had pneumonida, and still do, and cultures came back postivie for certain bacteria and they had to changed the antibiotics i was taking...

    like him i am still cough cough cough, grrrrr!!!

    inh + neb helping at times for a little while, then again cough cough cough! ....

    x x x

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