Parents reported noticing signs such as coughing, wheezing, shortness of breath, chest tightness or pain, cold or allergy symptoms, or even behavioral signs such as becoming quiet or more temperamental.
"Every time the child had an exacerbation, many parents noticed the same medley of signs preceding it," says Jane Garbutt, M.B., Ch.B., associate professor of medicine and of pediatrics. "But even though they noticed the signs consistently, they often didn't do anything about it. If parents had known to give albuterol earlier, they may have been able to manage things at home and avoid a trip to the emergency room," says Garbutt, also director of the Washington University Pediatric and Adolescent Ambulatory Research Consortium.
Garbutt says one of the reasons parents may not begin treatment is that they believe they are following doctor's instructions.
"The asthma plan from the doctor often says to start using albuterol when parents notice the child is wheezing or coughing or short of breath, but the doctor may have a different definition for those symptoms than the parent," Garbutt says.
Another problem the researchers found was that parents may not notice some of the early signs that predict an exacerbation. One in four parents who was interviewed reported seeing late signs of an exacerbation in the child, including gasping for breath or sucking in the rib muscles when breathing.
"Those kids have to go to the emergency department because they are too far along in their exacerbation to do anything at home," Garbutt says. "If we can talk to parents and find out that's the issue, we can teach them to take action sooner."
In some instances, parents knew they needed to give their child albuterol, but weren't sure how much or how often.
"Parents varied in terms of how often they used it, if they us
|Contact: Beth Miller|
Washington University School of Medicine