Tag Archives: Respiratory Medicines for Children

Guest Post: Treating Children with Special Needs in the Emergency Department by Dr. Christina Johns

[Note: This is a sponsored guest post contributed by Dr. Christina Johns, Senior Medical Advisor at PM Pediatrics. This was originally published on her blog, Dear Dr. Christina.]

Anyone who likes going to urgent care or the emergency department, raise your hand!
Anyone? No one?

That’s right. Nobody likes it for any reason, anytime.  It’s stressful, often unplanned and disorganized, and can be a frustrating experience.  I put my doctor head together with a few parents who live this firsthand, and we came up with some ideas that might help make the journey just a little easier.

One of the most helpful things you can do takes place before an emergency ever happens: that is PREPARE for the “just in case.” Make a detailed list of your child’s medical and surgical history, including all medicines with strength and dose.  I can’t tell you how many times a parent will forget to mention their child’s underlying diagnosis when I meet them for the first time. This is not because they want to keep something from me. It’s just not the first thing on their mind in an emergency.  A child with a brain shunt may have stomach pain and vomiting that doesn’t SEEM related to the shunt, but it may very well be. So having a handy and complete summary of your child’s medical “story” is a godsend to most clinicians, and can help your child and save time, too.  Same thing goes with any medical equipment or special dietary items (like liquid nutrition).  Bring these.  Just in case.

Also, I want to empower all you caregivers out there to remember that you have as much expertise about your child as the medical team.  After all, YOU live with your child every day, so don’t be afraid to speak up. Tell the doctor about the details that are unique to your own child, and tell them what you think, even if it “goes against” the medical convention.  It’s a team effort, friends, and just as I’ll ask you to be patient and flexible with the medical team, the clinicians need to LISTEN to you and incorporate your input as well.  This is a big deal.  If you feel like you aren’t being heard, then by all means speak up and say just that.  If you do this in a collaborative and respectful way, any solid medical provider should pause and redirect their focus to make sure you are being heard.

You are your child’s best advocate!

It nearly always helps to have your doctor give a “heads up” phone call to the urgent care or emergency department staff to let them know that you are coming in. Getting all the doctors’ brains on the same page really can make the visit go smoother. So please call your doctor if you can before you head on in to urgent care so that this communication can take place.

I wish you every good vibe as you navigate what can sometimes be a very tricky road!
That being said, if you can try to be as well prepared as possible for an unexpected trip to the emergency department, it will help you to focus on what’s really important: comforting your child.

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Christina Johns, MD, MEd is the Senior Medical Advisor at PM Pediatrics. As a parent, pediatrician, and pediatric emergency physician with a master’s in education, she shares her own expertise, plus the wealth of knowledge from their highly skilled staff, with patients and families everywhere.


Follow Dr. Christina online for health tips, insightful articles, and more.
Blog: https://www.pmpediatrics.com/dear-dr-christina/
Facebook: https://www.facebook.com/DrChristinaJohns/
Instagram: https://www.instagram.com/deardrchristina/
Twitter: https://twitter.com/DrCJohns
Pinterest: https://www.pinterest.com/deardrchristina/

This post is sponsored by PM Pediatrics, however, I only promote services, programs, and places that I genuinely believe in and think will appeal to KFDC readers.

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Guest Post: Controlla, Controlla by Dr. Christina Johns

[Note: This is a sponsored guest post contributed by Dr. Christina Johns, Senior Medical Advisor at PM Pediatrics. This was originally published on her blog, Dear Dr. Christina.]

You know what?  There are a lot of different respiratory medicines around–seems like a lot of people have trouble breathing.  And I’m not really talking about coughing; mostly I’m talking about being short of breath or wheezing. If you’re confused about keeping all these medicines straight, you’re like many of the patients that I’ve seen recently, and you aren’t alone. I’ve left work these past few times feeling like lots of folks are using their medicines incorrectly, and as a double whammy, the packaging looks alike.  And—sort of a true confession—I was also inspired to write on this topic when I heard that Drake song “Controlla.”  Alright.  You got me.

See, breathing medicines for people who wheeze regularly are divided into two categories:  rescue medicines and controller medicines (see recent Drake tune).

What I’ve noticed is that many people stop taking the controller medicine when they or their child aren’t having breathing difficulty, then start it up again when the wheezing or chest tightness begins.  Well, folks, that’s an excellent way for that medicine NOT to work.  The controller medicines are typically inhaled steroids (not anabolic steroids, rather an anti-inflammatory kind) that only go to the lungs and when given regularly decrease acute wheezing flares.  This means you have to use these medicines DAILY to achieve the desired effect.  They come in both inhaler form (like a pump spray) and nebulizer form (aerosolized via a machine).

In contrast, the RESCUE medicines are the bronchodilators.

These run the gamut from short acting medicines (albuterol is the most common one) that can be given frequently to long acting formulations that only need to be given once a day.  For MOST people, daily use isn’t needed, and these medicines are only effective when the airways are in spasm, which is part of what happens with wheezing/asthma.
So how do you know if you need a “controlla” medicine? (I kill myself! Haha.)  If your child needs to use the rescue medicine more than a few times a week and has regular nighttime awakening from symptoms, then it’s probably time to talk to your doctor about starting one.  Another day we should probably address the details on this, because it’s fairly well outlined.

During an acute flare, I like to tell my patients that if they are having to use the rescue inhaler more often than every four hours at home, then it’s time to get looked at.  In the monitored clinical setting these bronchodilators can be given continuously if needed, but I emphasize the word MONITORED here—it’s just not safe to be giving the rescue medications so often at home.

We could talk for hours about wheezing/asthma action plans and different nuances of medications, but mostly I wanted to write CONTROLLA a few times plus get the message out to everyone that you really need to know which medicine is which.  To review:

Inhaled steroid = CONTROLLA, needs to be used daily to be effective. 
Inhaled bronchodilator = RESCUE medicine, during an acute flare.
 
If everyone could do a little bit better job at the discipline part of keeping this sorted, then my guess is we’d all have a little more time for some groovy music, since we’d be spending less time dealing with our respiratory exacerbations.  I’ll jam to that.

* * * * *


Christina Johns, MD, MEd is the Senior Medical Advisor at PM Pediatrics. As a parent, pediatrician, and pediatric emergency physician with a master’s in education, she shares her own expertise, plus the wealth of knowledge from their highly skilled staff, with patients and families everywhere.


Follow Dr. Christina online for health tips, insightful articles, and more.
Blog: https://www.pmpediatrics.com/dear-dr-christina/
Facebook: https://www.facebook.com/DrChristinaJohns/
Instagram: https://www.instagram.com/deardrchristina/
Twitter: https://twitter.com/DrCJohns
Pinterest: https://www.pinterest.com/deardrchristina/

This post is sponsored by PM Pediatrics, however, I only promote services, programs, and places that I genuinely believe in and think will appeal to KFDC readers.

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Filed under Guest Post, Professional Service, Sponsored Post