Lack of Parental and Primary Care Control in Pediatric Asthma - Essay Example

? Lack of Parental and Primary Care Control in Pediatric Asthma Tanika Johnson English Composition II September 17, Carter Introduction Asthma is a chronic disease of the airways which carry air to the lungs. Asthma causes these airways to become constricted and their linings become swollen, irritated and inflamed. Very little information is available about the factors that lead to asthma; however intensive research has been done about the agents which trigger an asthma attack. Indoor as well as outdoor air quality consists of agents such as tobacco smoke, dust mites and cockroaches, which are responsible for asthma exacerbations (Platts-Mills, 1999). Children have narrow airways and rapid respiration rates. This puts them at an increased risk of asthma as compared to adults. The disease is much more widespread then it is believed to be. About 5.3 million children in America suffer from asthma (Adams, 1998). There are many advancements in asthma research and availability of medicine, yet morbidity and treatment costs are still extremely high (Fairfield, 2010). The high treatment costs can lead to a lack of proper parental care. The lack of health insurance in some families has also been shown to present an issue with lack of primary care control for pediatric asthma. Asthma can be properly controled if parents and primary physicians work together to properly plan and care for the affected child. Through, literature review, news articles, and treatment options lack of proper pediatric asthma care will be shown, as well as, how proper care can ensure a lower asthma incidence in the child and lower morbidity. Literature Review Recent studies have indicated that most of the asthmatic children are notable to achieve the optimal level of asthma control that can be obtained (Szefler, 2005). The difficulty with the treatment of asthma and the prevention of its exacerbation has been the widely different perceptions of what is meant by asthma control. Primary care and the ambulatory settings have been identified as the most efficient and effective level of care in order to prevent the exacerbation of asthma. A necessary component of asthma care includes the mitigation of the triggers-both indoor and outdoor that has been associated with the exacerbation of asthma. There has been evidence found through research that there is a direct relation between the socio-economic status of an individual and the exposure he faces to the various risk factors. Children who are staying in poor households and belonging to lower economic strata are more likely to suffer exposure to triggers responsible for asthma, as well as suffer from improper parental and even physician care. No detailed study has been available in the literature review which specifically deals only with the different aspects associated with the treatment of asthma. Most studies that have been associated with asthma deal with the triggers that have been responsible for exacerbations of asthma (Andrew Harver, 2008). A research paper conducted by L.Kay Barthlomew and other does talk in detail about the benefits of inhaled corticosteroids and their effectiveness (2006). News Articles The Chicago Sun Times reported that a family is suing three hospitals due to the death of their seven year old child as a result of improper asthma care (Korecki, 2011). The mother stated that no one explained anything regarding her son’s treatment just that they had to transfer to another hospital. The second hospital made the mother and son transfer again to a hospital thirty minutes away. Unfortunately before the boy reached the third hospital he died in the ambulance. The mother indicated she knew the routine they would have to sit in the hospital while her boy was treated and once given the treatment he would be fine. They were prepared to wait at the hospital as they had before. The boy was treated at home with an inhaler, but this treatment option did not always help resolve the more severe attacks. According to Perry, Texas it is one of the worst states and areas for proper treatment of health conditions including asthma (Tracy, 2011). Many families do not have insurance and therefore do not treat medical conditions such as flu, asthma, and hepatitis A. Doctors tell of uninsured children with preventable diseases or disorders like asthma that can be cared for, who die after being admitted too late to emergency rooms. Sadly, these two news releases are not the only cases in the United States of improper care both on the part of parents and physicians. Treatment of Asthma Treatment of Asthma has been divided into two basic categories- long term medications and quick relief medications which are extremely helpful whenever an asthma attack occurs. Before treatment can be administered the cause of the asthma symptoms needs to be known by the doctors and parents. Some of the common symptoms of asthma are coughing, wheezing, troubled breathing, chest pain and recurring bronchitis. The most important thing to consider in the case of asthma diagnosis is to correctly identify the triggers responsible for exacerbation of asthma and which symptoms are related to an asthma attack rather than a simple cold. This occurs by studying how often the episodes of coughing and wheezing occur in the child and also examining the severity in each of these episodes. Smoking has been identified as one of the most common causes which trigger asthmatic attacks. Later an explanation regarding the importance of proper diagnosis will be examined in order to discuss proper care of the child. Long Term Medications Inhaled Corticosteroids Inhaled corticosteroids are used for long term control of asthma. They are usually the preferred choice of doctors for curing persistent asthma. They are helpful in controlling the inflammation of bronchial tubes (Peter J. Barnes, 2008). These medications have to be used every day for long term benefits. They might even be used twice a day in severe cases. Cromolyn Cromolyn is again a drug which is not very effective when taken alone but produces good results when it is taken in combination with inhaled corticosteroids. The only negative point of these drugs that I see is that they have to be taken at least 2 to 4 times in a day. They are also not very effective in the severe cases of asthma but work fine in mild to moderate asthma cases. If the child is small than convincing him to take these medicines 2-4 times a day will be a very problematic and cumbersome task for the parents. It is a high possibility that many dosages might be missed which might reduce the over-all effectiveness of the drug. (Szefler, 2005) Combination Inhalers Combination inhalers in simple terms are those inhalers which combine two drugs into one inhaler. It is believed that combining these two drugs will improve the efficiency of the drugs than when they are used alone in a single inhaler. Advair and Symbicort are controller medications that combine two drugs into one inhaler. These mediations contain an inhaled corticosteroid along with a long-acting (LABA). These medications should not be given to children unless combined with a corticosteroid. Rescue Medications Rescue medications are also called as short-acting bronchodilators. They provide immediate relief from asthma symptoms in the case of an emergency. The effect of these rescue medications usually lasts from about 4 to 6 hours. Albuterol is the most commonly used one. Some of the other examples of short-acting bronchodilators are pributerol and levalbuterol. These medications are for emergency only and are not a cure or permanent relief option. Frequent use of quick-relief inhalers has been proved to be very dangerous for long term health of the child. These may even increase the severity of asthma attacks in future. These inhalers should be used strictly in the case of emergencies. Parents should also consult their doctors immediately after the use of these medicines. Immunotherapy for allergy induced Asthma Allergic Asthma is a kind of asthma which is triggered by certain circumstances or certain things. (Peter J. Barnes, 2008) Some triggers such as cigarette smoke can be controlled by creating a smoke free environment at home; however it may not be possible to control all the triggers which are responsible for an asthma attack .Allergy-desensitization shots are given to help children overcome these triggers. These injections contain small dosages of those allergens. These injections are given for a period of three to five years once a week. Asthma symptoms due to the triggers will gradually decrease over time as the body becomes immune to the allergens. Key to Asthma Control Diagnosis of pediatric asthma will indicate what may trigger the asthma attack. In the treatment section several long term options, rescue medicines, and immunotherapy were discussed. Each treatment was examined for the severity of asthma it may control and when it should be used. After examining the different medications and ways of controlling asthma it is possible to return to the most important aspect of this discussion- how treatment should be considered by parents and primary care physicians in order to help and prevent asthma attacks in children as a means to prevent death and offer a healthy life. The care and concern parents and doctors show regarding pediatric asthma will ensure lower death rates and a healthy life. Learn About Asthma The most important thing for parents to do is to learn about asthma. Whenever an attack occurs, a doctor will not be available around the corner. Parents should make efforts to learn about the different medications that have been prescribed to their child and which medicine has to be taken in which case. A child will not be able to analyze his symptoms himself; parents have to do it for him. They need to be aware of the signs that Asthma is getting worse .Whenever such signs become visible immediate action should be taken. I strongly believe that if parents take the pain of educating themselves about this half the cases of hospitalization due to severe attacks will be lessened and such cases as Aaron Pointer will not occur (). Track Symptoms This is the most important part. Parents should not only track the symptoms but should also write it down. They should make a note of the points when the exacerbations occur. They should make a note all the triggers which come in proximity to the child and cause attacks. Apart from tracking the triggers which cause exacerbations parents should also write down the reaction that a child has whenever flare ups take place. These written reports if presented to the doctor will solve half his problem. Asthma is a behavioral disease and a doctor cannot be present all the time with a child to note down his behavior. This has to be done by the parents. They should also make a note of the medicines which have been prescribed by the doctor. Give these medicines religiously to your child. Note down the change in symptoms of asthma after medication starts. This will help a doctor know if a particular medicine is working or not. Once a doctor has concrete information in the form of these written reports from the parents; he will not resort to trial and error in dealing with your child’s Asthma. Trial and error is indeed the method used by most of the doctors in managing asthma. It is also how children can suffer greatly from the disorder. Treatment takes two educational backgrounds to be successful. The first educational background is the doctor who has the scientific education to offer various courses of treatment. The treatment can only be most effective when the second educational background is present which is that of the parent. When a parent provides detailed information regarding the child and reduces any known allergens in the home and outdoors, asthma can be lessened. Without the involvement of both parent and doctor, the child will suffer the most and possibly die. In the case of little Aaron Pointer, his parents were aware of the asthma and had basic emergency medicine to help prevent attacks. They relied heavily on the emergency medical services and placed their trust in the doctors helping them. This assumption led in part to his death. Had more extreme measures been taken at home with medications to control severe attacks and not emergency medicine there is a chance the boy would have survived as he would not have needed emergency room treatment. Though this may seem harsh and not all information is known about his case just what has been reported, it is nonetheless a fair statement. Parents have to be extremely involved in their child’s care not just rely on doctors to tell them what to do. A lack of understanding by the parent’s can and has repeatedly led to the death of children by asthma. Conclusion Parents who plan accordingly for their child’s asthma attacks can prevent more severe attacks from occurring. Medicines are not a cure for asthma but a way to manage the disorder. Parents who lack proper control or understanding of their child’s asthma risk harming their children. The parents have to take their children to a doctor regularly for checkups regarding their asthma. Without this step a doctor will not be given the chance to help the child and possibly provide a healthy and normal life for the child. There are several helpful treatments that can be used individually or as a combination. Understanding the triggers of an asthma attack can also lead to prevention of more severe attacks. Simply stated it is the opinion of this writer that severe asthma attacks and morbidity from asthma can be prevented if proper parental and physician care is provided to the child. Asthma is a result of a constriction due to inflammation of the lungs that can be alleviated though not wholly cured. References Adams, F. V. (1998). The Asthma Sourcebook. New York: McGraw-Hill Professional. Andrew Harver, H. K. (2008). Asthma , Halth and Society : A Public HEalth Perspective . New York: Springer. Fifefield, Judith, Ph.D. (2010). Improving Pediatric Asthma Control Among Minority Children Participating in Medicaid: Providing Practice Redesign Support to Deliver a Chronic Care Model. Retrieved from 0-web.ebscohost.com.odyssey.aurora.lib.co.us Jan, Tracy. (2011). A Deep Health Care Divide in Perry Texas. Retrieved from articles.boston.com/2011-09-25/news/30201319_1_health-care-preventative-care Korecki, Natasha. (2011). Family sues, asks why Asthmatic Boy sent to 3 hospitals in 11 hours. Retrieved from www.suntimes.com/7869020-418/family-sues-asks-why-asthmatic-boy-sent-to-3-hospitals-in-11-hours Peter J. Barnes, J. M. (2008). Asthma and COPD : BAsic MEchanisms and Clinical Management . New York: Academic Press. Platts-Mills, T. (1999). Asthma : Causes and mechanism of an epidemic inflammatory disease. USA: Thomas Platts-Mills. Szefler, S. J. (2005). Childhood Asthma. USA: Mercel Dekker. Read More