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Children's health

Prednisalone/Salbutamol/Nebuliser for 17mo - advice please?

9 replies

COCKadoodledooo · 19/04/2011 21:54

And just general reassurance? Worried about my baby Sad Just back from OOH with him.

Ds2 is 17mo. Christmas time he had a bad persistent cough, and we were given a salbutamol inhaler (same as mine) and an Aerochamber spacer, to use 'as necessary'. Tbh we didn't give it to him for longer than a couple of days (he HATED the spacer plus his cough cleared up pretty well). No problems since.

Fast forward to this weekend - Sunday I noticed his nose was a bit runny, and as my hayfever symptoms were bad I didn't think much of it (not that he can have hay fever of course, because he's under two Hmm ). Yesterday he was coughing a bit, enough to keep him awake part of the night. This morning he seemed chipper enough.

I was out all morning, then dh took the boys out this afternoon. When they got back he said he'd been coughing a lot, then started wheezing a wee bit. Decided to give him a couple of puffs then, and he took them with no fuss at all, bless him. Didn't seem to last long though, and about half an hour later he picked it up and brought it to me. Again it didn't last long (and of course this was literally 4 minutes after our surgery switch off their phone..), so called OOH.

Triage said they'd call back 'soon', but it was within 5 mins, doc said to take him straight in but give him 6 puffs first. Of course when we got there he was bouncing off the walls! (that's the only side effect I know of with salbutamol, are there any more I should be looking for?). Detailed examination, then doc gave him a 5 minute salbutamol neb, which was horrific frankly Sad Ds2 was terrified, screaming his head of (he hates noisy machinery, that being coupled with a mask over his face was his idea of hell I'm sure!).

After he'd settled down, doc gave 20mg of prednisalone. We've the same dose to give him tomorrow and the day after. Anything to look out for with that one? I always took Becotide as a child, not sure how different it is and frankly it was a long time ago so I don't remember side effects!

Doc said he was borderline for being kept in, but was happy for us to go home as long as we were happy treating him, and because we're 20 mins from the hossie so we can take him straight in if necessary.

We've to give him 6 puffs every 2 hours for the next 6 hours, then 4 every 2 or 3 after that depending how he is.

Aside from making him hyper, are there any other effects we might see? It's been a long time since I had a proper attack and I don't really remembr. Vaguely recall getting pretty grouchy though.

He's now had a bf and is sleeping peacefully (and thankfully not too noisily!) beside me. Do I need to rouse him for his next salbutamol, or can it be done when he's sleeping?

Any advice gratefull received, cheers.

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Sirzy · 19/04/2011 22:01

Hi. I wouldnt worry about using the prednisilone DS has had 4 courses (I think, possibly 5) and he is the same age as your LO. I did find it made him a bit hyper towards the end of the course but that could have just been him getting better. (Last time he had it he was walking laps of his cot for 20 mins whilst still on oxygen!)

Try the inhaler when he is sleeping, hopefully he will sleep through it DS rarely does though!

The nebs are horrible arent they. DS hates them with a passion it normally takes at least 3 people to get him to take them!

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verybored · 19/04/2011 22:05

Aw poor little mite. I've found it can give them headaches and occasionally the shakes, usually only after 10 puffs with mine though.

I would make sure he's sitting up for his inhaler so that you know he is getting it properly. You may be able to do this only rousing him slightly.

I would keep a close eye on him the day after you stop the pred and for the next few days after that as at the moment that will be what is keeping his lungs happy. Hopefully he will have recovered sufficiently by the time you stop giving it but there is a chance he could struggle again.

If there is anything at all that worries you, do not be afraid to take him back, even if he doesn't seem 'bad enough'. If they can be treated early on, it can make the whole thing shorter and easier to get over.

We have always called nebs 'noisy inhalers'. It really is horrible isn't it as you have to struggle to hold the mask on and you feel awful doing it Sad

I hope he recovers quickly and you can manage to get some rest.

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Jojay · 19/04/2011 22:19

Poor you and your DS - it's so horrid isn't it?

Both my boys get wheezy and have been treated numerous times as you describe.

Neither has had any side effect to the pred - it's brilliant stuff and a 3 day course has never failed to sort them out.

They have though, as you describe, both become pretty hyper on Salbutamol. They have also got very shaky and jittery, but again, it works a treat and it's worth putting up with.

When mine have been admitted, nurses have given nebulisers and puffs through spacers at night when they are asleep, and they haven't woken them or moved them into a sitting position.

I've given it through a spacer while they're asleep lots of times, and it is important to stick to the times they have given, as they can go downhill again, but there's no need to wake them.

Hope he's feeling better soon - in my experience, once the drugs kick in, they normally turn the corner pretty quicky and I'm sure in a day to two he'll be as right as rain Smile

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COCKadoodledooo · 19/04/2011 22:20

Thanks both Smile Those are the sort of things I forgot to ask.

I didn't have a neb as a child until I was about 6 so could understand what it was for etc. Not in a hurry to go through it again with him!

Managed the inhaler asleep! His head's on the pillow, so he wasn't properly upright but his airway was open and I could see the wee valve going up and down. Hoping for a repeat performance at midnight now.

Thanks again.

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COCKadoodledooo · 19/04/2011 22:22

Thanks to you to Jojay, you must have posted as I was typing. Dh is going to do the midnight one and my alarm's set for 2, so I'd best go get some sleep!

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Sirzy · 19/04/2011 22:28

Glad he took it ok asleep x

When Ds is in hospital they always sit him up for Nebs but give the inhalers when sleeping without moving him (cot head always raised anyway)

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isthismadness · 20/04/2011 00:42

If he gets worse or you're not happy then take him to a+e in the night. Their condition can change even with treatment so don't worry about looking silly. If you're worried or his work/ rate of breathing increases get him seen again
Good luck x

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COCKadoodledooo · 20/04/2011 10:02

Thanks peeps. He is SO much brighter this morning!

Dh did the midnight inhaler, and he woke halfway through. Settled down pretty quick though. I did the 2am, and he was rousing a bit anyway, so it was a wee bit of a struggle but we did ok.

I woke at 6 and was immediately really worried, because I couldn't hear him wheezing! Panicking I turned his face towards me and realised he was breathing just fine, just was nowhere near as rattly as he had been. Phew!

He has been a bit crackly again this morning, but 2 puffs sorted him out, so he's definitely improving. Will keep a close eye on him and take him back if he worsens again.

Thanks again for the sympathy and advice.

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Sirzy · 20/04/2011 12:57

Glad he is on the mend

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