Understanding Asthma and Anaphylaxis in Children: A Guide for Childcare Providers and Educators

As childcare providers and educators, your role in safeguarding the health and well-being of children is vital. Asthma and anaphylaxis are two serious conditions that require immediate attention in emergencies. Knowing how to recognise the signs and provide first aid can save a life. In this guide, we’ll explore the similarities and differences between asthma and anaphylaxis, how symptoms may vary between young and older children, and how to manage these conditions effectively.

Asthma and Anaphylaxis: An Overview

What Is Asthma?

Asthma is a chronic condition that affects the airways in the lungs, causing inflammation, narrowing, and increased mucus production. It can be triggered by allergens (dust mites, pollen), respiratory infections, exercise, cold air, or irritants like smoke. While asthma is a long-term condition, it has the potential to be life-threatening if not managed promptly during a severe attack. Let’s break down childcare and education first aid for asthma.

What Is Anaphylaxis?

Anaphylaxis is a severe allergic reaction that can be life-threatening and usually occurs rapidly after exposure to an allergen. Triggers include foods (e.g., nuts, shellfish), insect stings, medications, or latex. Anaphylaxis can affect multiple body systems and requires urgent medical attention.

Similarities Between Asthma and Anaphylaxis

• Breathing Difficulties: Both conditions often involve respiratory distress.
• Trigger Response: Exposure to allergens can exacerbate asthma or cause an anaphylactic reaction.
• Action Plans: Every child with asthma or allergies should have a written action plan.
• Emergency Nature: Both conditions can escalate quickly, requiring swift first aid and medical intervention.

Key Differences

Recognising Symptoms: Young vs. Older Children

Symptoms in Young Children

• Asthma: A young child may display subtle signs such as rapid breathing, grunting, difficulty feeding, lethargy, or saying they “feel sick.” They may appear unsettled or frightened.
• Anaphylaxis: Symptoms may include inconsolable crying, drooling (due to throat swelling), a rash, swelling, or vomiting and diarrhoea.

Symptoms in Older Children

• Asthma: Older children often articulate their symptoms, such as “my chest feels tight” or “I can’t breathe.” Wheezing and persistent coughing are common.
• Anaphylaxis: Older children may report a tingling or itching sensation in their throat or tongue, feeling faint, or a metallic taste in their mouth. Swelling and difficulty breathing are prominent.

First Aid Management: Asthma

When managing asthma or any medical emergency, always follow the DRSABCD Action Plan:

1. Danger: Ensure the area is safe.
2. Response: Check for responsiveness.
3. Send for help: Call 000.
4. Airway: Check and clear the airway.
5. Breathing: Look, listen, and feel for normal breathing.
6. CPR: If not breathing, commence CPR.
7. Defibrillation: Use an AED if available and trained to do so.

Steps for Asthma Management

1. Sit the Child Upright: Keep the child calm and encourage slow, steady breathing.
2. Administer Reliever Medication:
   • Shake the puffer.
   • Administer 1 puff, followed by 4 breaths.
   • Repeat this step 4 times. Shake the puffer between each step.
3. Monitor and Call for Help: If symptoms do not improve after 4 minutes or worsen, call 000 immediately.
4. Repeat Medication if Needed: Continue administering reliever medication every 4 minutes while waiting for medical help.

First Aid Management: Anaphylaxis

Steps for Anaphylaxis Management

1. Lay the Child Down: Keep the child lying flat unless they are struggling to breathe or resisting, in which case they can sit upright.
2. Administer Adrenaline Immediately:
   • Use the child’s adrenaline auto-injector (e.g., EpiPen).
   • Remove the safety cap and press the device firmly into the outer mid-thigh, holding for 3 seconds.
   • Note the time the adrenaline is administered
3. Call Emergency Services (000): Even if the child seems to recover, an ambulance must be called for further medical assessment.
4. Monitor and Reassure: Stay with the child, monitor their condition, and be prepared to administer a second dose of adrenaline if there is no improvement after 5 minutes.
5. Do Not Leave the Child Alone: Continue monitoring and providing comfort until help arrives.

Importance of Action Plans

Every child with asthma or a known allergy should have a personalised Asthma Action Plan or Anaphylaxis Action Plan prepared by a healthcare professional. These plans outline symptoms, triggers, and step-by-step emergency management tailored to the child’s needs. Copies of these plans should be kept readily available at all times and shared with all staff members.

Scenarios

Scenario 1: Asthma in a Toddler

Liam, a 3-year-old, begins coughing and wheezing after running outside. He tells his educator he feels “sick and has a sore tummy”. His face looks pale, and his breathing is laboured. The educator refers to Liam’s Asthma Action Plan, and administers his reliever puffer as directed. After three minutes Liam’s colour is normal and his breathing is no longer laboured. Liam’s parents are notified about the episode. They come and collect him from day care and he is reviewed by his doctor.

Scenario 2: Anaphylaxis in an Older Child

Sophia, a 10-year-old, known to be anaphylactic, accidentally eats a nut-containing snack while at a friend’s birthday party. She reports her throat feels “itchy,” and her face begins to swell. A first aid trained parent lays Sophia flat and helps to keep her calm. Sophia has her EpiPen with her. The EpiPen is quickly retrieved and administered. The parent then keeps Sophia calm and reassures her while an ambulance and her parents are called. 

The Critical Role of First Aid Training

Emergencies involving asthma or anaphylaxis can escalate quickly, but knowing childcare first aid can save lives. All educators and childcare providers should undergo accredited first aid training to confidently handle such situations.

Take Action Today

Enrol in a comprehensive first aid training course with My First Aid Course Brisbane. Learn essential skills, including how to administer an adrenaline auto-injector, use an asthma puffer correctly, and follow emergency action plans.

Be Prepared to Protect Young Lives

Understanding asthma and anaphylaxis is crucial for anyone caring for children. Recognising symptoms, knowing how to act, and following each child’s action plan can prevent emergencies from becoming tragedies. Equip yourself with the knowledge and skills to respond effectively—because a child’s life could depend on it.