When To Take Wheezing Seriously (ER)
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Comment| Wednesday, April 16th, 2008 | Emily Halevy | CWK Producer |
“If a child gets so sick that they need oxygen, that they’re working so hard to breathe that I’m scared they’re going to lead themselves to respiratory failure or tucker out, or if they’re working so hard that they can’t maintain their hydration and they need to stay in the hospital.”
– Michael Mallory, M.D., Children’s Healthcare of Atlanta
Many of the most common childhood illnesses share at least one common symptom: wheezing, or difficulty breathing. The cause could be a cold or the flu; it could also be asthma, whooping cough or a viral infection in the lungs. When do you need to take it seriously? One answer is when your child is working very hard just to breathe.
Two-month-old Wesley is having trouble breathing; a few hours ago he was turning blue. The doctor suspects a viral infection that 99 percent of all of us get during childhood. It’s called Respiratory Syncytial Virus (RSV).
“Respiratory Syncytial Virus, according to many studies and in reality, is responsible for the majority of what’s called bronchiolitis,” says Dr. Michael Mallory, M.D., Children’s Healthcare of Atlanta.
To explain, he makes the comparison of lungs to a tree. The trunk and the large branches are the main airways; an infection in those areas is called bronchitis. An infection of all the twigs at the end of the branches is called bronchiolitis, and it can be serious.
“[It’s serious] if a child gets so sick that they need oxygen, that they’re working so hard that I’m scared they’re going to lead themselves to respiratory failure or tucker out, or if they’re working so hard to breathe that they can’t maintain their hydration and they need to stay in the hospital. And certainly Wesley qualified for admission,” says Mallory.
“I’m just concerned with the way that he’s breathing right now; I’m a little reluctant to send [Wesley] home,” adds Mallory.
“That’s fine. We’ll stay as long as we need to,” says Wesley’s mom.
In fact, Wesley is admitted to the hospital and is now in treatment.
“The very frustrating thing about it is nothing really seems to work,” says Mallory.
He says asthma medicine may help sometimes; Epinephrine provides temporary relief. But mostly, Mallory advises, you just treat the symptoms.
“You know, suctioning the nose out, giving oxygen, supporting the respiratory effort as much as we’re able to,” says Mallory.
In time, Wesley’s own body and immune system will kill the virus.
Tips for Parents
- Among the most common symptoms of lung disorders are cough, shortness of breath (dyspnea) and wheezing. Less commonly, a blockage in the airways between the mouth and lungs results in a gasping sound when breathing. (MERCK)
- A wheeze is a high-pitched whistling sound made when air flows through narrowed airways in the lungs, usually when people breathe out. Wheezing is a common symptom in people who have asthma, although people can wheeze for reasons other than asthma. A doctor can listen for wheezing through a stethoscope, but sometimes wheezing can be heard even without a stethoscope. (Nemours Foundation)
- Problems in the lungs can also lead to coughing up blood (hemoptysis), a bluish discoloration of the skin due to a lack of oxygen in the blood (cyanosis) or chest pain.
- Wheezing results from an obstruction somewhere in the airways. It may be caused by widespread narrowing of the airways (as in asthma, chronic obstructive pulmonary disease, and some severe allergic reactions), by a local narrowing (as with a tumor), or by a foreign object lodged in an airway. (MERCK)
- Wheezing is relieved with bronchodilators, such as inhaled Albuterol. Corticosteroids, taken by mouth for a week or two, can often help relieve an acute episode of wheezing if it is due to asthma or chronic obstructive pulmonary disease. (MERCK)
- While RSV may just cause a cold in older children, it can cause a serious and life threatening infection in younger high-risk children. (MERCK)
- Some doctors aggressively treat the wheezing with nebulizer treatments and steroids, as they would for a child with asthma, while many others feel that nebulizers have no affect. Others try breathing treatments and continue them if a child has a good response. (MERCK)
References
- Nemours Foundation
- MERCK
- Children’s Healthcare of Atlanta
