Breathless toddler

[bumperella]

My DD was admitted to hospital for 5 days about 6 wks ago, with breathlessness from a chest infection. She needed overnight oxygen for all 4 nights but was fine in the day by day 4 and 5. We gradually reduced salbutamol dose (as recommended) and were happy to put it down to a one-off "wheeze", as she appeared to recover fine.

She was breathless again at weekend, took her into OOH again. Her oxygen was at 92 but came up to 94 after one dose of oral steroid and salbutamol inhaler. Triage nurse said oxygen too low, so admitted to hospital ward. This at 7pm; dr on ward had a look at her (listened to chest and heard no gunge, looked in ears (fine) and down throat (a bit red)), discharged at 8pm; her sats were at 96 and dr couldn't hear any wheeze. No follow up treatment or investigation needed (per dr's), just give salbutamol every 4 hrs for the next 24 hrs.

Obviously you get home, then the following evening you google. (why?? WHY??). 96 for an (awake) 2 year old is pretty low, and to be at 96 with no wheeze isn't good news? I'm a bit worried that a weekend emergency admission isn't likely to lead to proper investigation. I went to the GP this morning who was nice enough, but wasn't able to give any further advice. Should I worry? Or am I being hysterical google-er?

96 is fine though. It's not perfect but it's fine.

Is she still breathless now?

Is she prone to chest infections or coughs? Does she get hayfever or eczema?

My dd has asthma and has a very difficult to detect wheeze. Our GP finds it difficult to hear but we are so familiar with her symptoms now we know when she needs help.

Does your daughter have a cough? Does she have a blue-ish tinge around mouth?

If you look at base of throat is it sinking in farther than usual?

Any tugging of skin between ribs?

These are things to look for.

Yep, she's continued to be breathless since; better today, but pretty bad last night and tonight and whilst she was asleep. I guess my concern is that having oxygen at 92-ish when she was admitted isn't good, but there didn't seem to be any proper cause of it.

The triage nurse did say that (a) they don't diagnose asthma for under-5's, and (b) that it wouldn't be likely as she's not had any inhalers or symptoms for over a month (ie if you had asthma and didn't treat it for a month then you'd expect to have some symptoms).

It depends. Some asthma needs treating daily, other times it flares up as a cold that's gone to the chest and requires the blue inhaler and sometimes steroids to deal with. Dds asthma at its worse was always viral induced, we could go a few weeks at a time with no treatment at all.

Of course changes in weather did sometimes affect it too

No blue colour, her tummy is working a bit but really it's not (now) severe breathlessness. it's not urgent, and am not immediately worried. BUT I don't know what to ask the dr and can't really believe that it's "normal" to have unexplained low-ish oxygen levels like this?

I think 92% is quite low. Can you count her respirations per minute? Each in and out is one resp. Then look up the average for her age? This will give you an idea of how fast her breathing is.

wheresmycaffeine drip - cross posted, that's hugely helpful, I didn't realise that! Thankyou.

I would ask the surgery if any of the GPs have an interest in asthma, and get her seen again. It sounds like you suspect she might have it?

They don't 'diagnose' asthma in small ones yes, but that doesn't mean they don't have it

And I don't know where she got the under five thing. Every single asthmatic child I know including dd was under five. The olderst was 3.5-4.

She said that under-5's grow out of it too quickly to warrant labelling it as asthma - and also the blerb about it being untreated and no symptoms. I may regret saying this, but I find asthma a less scary prospect than other lung conditions I can think of (I have asthma and don't find it more than an inconvenience really).

All I can say is , things improved when I heard the words "asthmatic". Before then, it just was something that flared up of which I had no idea when or how to treat I had an inhaler for as and when. Once I knew, I was far more vigilant with regards to coughs and colds and I was able mostly to keep it manageable. Label or not I think your best off thinking of her as potentially asthmatic and applying the observations that you would with a diagnosis rather than assuming its a one off, if that made any sense. Just because they sometimes grow out of it doesn't mean thy don't have it or can't be treated as if they have it.