
As an ER physician, I’ve seen firsthand the difficulty parents of children with asthma have in deciding whether or not to bring their child to the ER. Parents don’t want to put their child at risk, yet they don’t want to make an unnecessary trip to the ER. The best advice? Put together a plan with the advice of your pediatrician and stick to it. In this manner, when your child is having an asthma attack you have clear indicators and steps to follow. Ask your pediatrician to help you determine what symptoms and - if your child uses one - what peak flow meter readings indicate a trip to the ER.
In general, if you notice any of the following symptoms, seek immediate medical care.
- Bluish or gray lips, skin or fingernails.
- A peak flow reading below 50% that doesn’t improve after giving your child medication.
- Severe symptoms that reappear, peak or don’t go away despite repeated use of medication. If symptoms return quickly - within 5 to 10 minutes of using medication, contact your doctor.
- Difficulty speaking.
- Retractions - areas of skin around the base of the neck or between the ribs that pull in when your child inhales.
Finally, one of the biggest risk factors that triggers asthma is exposure to second hand smoke. This means parents shouldn’t smoke in the home or car at any time, because smoke permeates drapes, carpet, and fabric, and this can set off an asthma attack.

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