When children cough repeatedly, parents are most worried about whether they will cough up pneumonia.
Pneumonia is not a particularly serious disease for doctors, but parents are still quite afraid of it. Every time I meet a child who has had fever and cough for three or four days in the clinic, if the parents are told that it is bronchitis after auscultation, they will feel relieved. If the child has pneumonia, parents often have a look of collapse, and some mothers even cry in an instant.
Compared with common respiratory infection, pneumonia is a serious disease. However, after anti infection and symptomatic treatment for most pneumonia, the results are relatively good (of course, there are also very serious pneumonia, with poor prognosis). There will be no sequelae, nor will it cause repeated pneumonia. Parents need not be anxious.
So let's take a look at the general situation of pneumonia first, so that parents will not be so flustered.
What is pneumonia?
Pneumonia is inflammation of the terminal airway, alveoli and pulmonary interstitium. To make a vivid analogy: the whole lung is like an inverted tree. The trunk of the tree is the main trachea, and gradually branches down to bronchi, bronchioles, and bronchioles, while the alveoli are like the leaves of the tree. Inflammation of branches (trachea and bronchi) is tracheitis and bronchitis, and inflammation of leaves (alveoli) is pneumonia. Branches and leaves are connected. Bronchitis is the inflammation of branches, pneumonia is the inflammation of leaves, and pneumonia is the extension of bronchitis. There is no essential difference between the two. So parents should not be afraid of pneumonia when they hear about it. It is only different from bronchitis in depth of infection, sometimes just a line away. The diagnosis of pneumonia needs to be determined by the doctor. As a parent, the most important thing to know is that what happens to the child may be "pneumonia", so as to see a doctor in time, so as not to delay the condition.
Children with pneumonia should be considered in the following cases:
● Newborn: Newborn pneumonia often has no symptoms such as fever and cough. The main manifestations of pneumonia are mental weakness, lack of milk, choking, spitting and other non respiratory symptoms. Therefore, when there is a respiratory patient at home, the child should be taken to see a doctor in time when the child subsequently has the above symptoms. Especially when the children are in low spirits, they should go to the hospital immediately.
● Infants: Infants with pneumonia often have obvious cough, and some babies also have fever symptoms. When the cough continues to worsen, breathing becomes faster, breathing becomes difficult in a quiet state, there is a nasal fan (the nasal wing moves when breathing), the mouth is green, the breast is reduced, choking and vomiting are obvious, irritability and crying are obvious or malaise, it may be pneumonia. At this time, parents should take the child to see a doctor immediately.
Tips
The baby's condition changes quickly. Sometimes it is necessary to see a doctor every day to observe the change of condition. It may be bronchitis the day before, pneumonia the next day, or even change on the same day.
● Children aged 2 or 3: children at this age often have obvious fever and cough due to pneumonia. When the child has high fever accompanied by severe cough for more than three days, and is depressed, unusually irritable or crying, be alert that it may be pneumonia, and parents should take the child to see a doctor immediately. The child has a fever first, and the fever gradually subsides and then cough occurs. The probability of pneumonia is relatively low, while the child has a cough first, and the cough gradually worsens. When the cough worsens, fever occurs at the same time, and the probability of pneumonia is relatively high.
● School age children: mycoplasma pneumonia is more common. The typical symptom is a severe cough, often accompanied by fever, and the body temperature is generally high.
Prevention of pneumonia
No matter how much doctors emphasize not to be nervous, parents are still worried about the occurrence of pneumonia, so parents may wish to learn some effective ways to prevent pneumonia. In fact, the prevention of pneumonia is similar to that of common respiratory tract infection:
● Room ventilation by opening windows: reduce the concentration of pathogens (especially when there are respiratory patients at home).
● Appropriate outdoor activities: increase the amount of activities and immunity.
● Less indoor crowded public places: reduce cross infection.
● Drink more water and rest.
Some misunderstandings about pneumonia
Myth 1: The film has radiation, which is bad for children.
The diagnosis of pneumonia usually requires chest radiography. I often meet parents who ask, "Can you not take pictures? Is there radiation when taking pictures?" First, X-ray films do have radiation. If it is not necessary for clinical use, doctors try not to take pictures.
However, the amount of radiation is very small. It is extremely rare for a chest X-ray to cause radiation sickness in children. Radiography can not only determine whether there is pneumonia, but also help doctors to judge the severity of pneumonia and possible pathogens (different pathogens often have different characteristics on chest radiographs), which helps doctors to choose treatment plans and judge prognosis.
Myth 2: It hasn't improved after two days of treatment. Should I change a drug?
Outpatients often encounter such children with pneumonia, whose temperature still does not drop after 2 days of intravenous infusion of pneumonia, and whose cough is not obvious, so parents are very anxious and want the doctor to change a drug. But you should know that any drug takes time to work, and no drug can have an immediate effect.
Clinically, relief of symptoms and signs after 2-3 days of treatment is a relatively smooth process of treatment. Often, symptoms and signs are not significantly relieved after 2-3 days of treatment. Generally, symptoms and signs are still not relieved after 3 days of treatment, which is the time point for clinical adjustment of treatment. Dressing will not be changed when it is difficult today and tomorrow. Frequent dressing changes are not only detrimental to the recovery of the disease, but also may cause drug resistance.
Although the prognosis of pneumonia is generally good, refractory pneumonia is not uncommon in clinical practice. Some children's temperature continues to rise during treatment, and the chest radiograph shows that the shadow in the lung does not decrease but gradually increases. At this time, more active treatment plans are needed: such as hormone, gamma bulb, bronchial flushing and other methods.
Myth 3: Antibiotics have a lot of side effects. If your child gets well, you'd better stop it immediately.
There is a course of treatment for pneumonia. Failure to complete the course of treatment may lead to repeated or even aggravated illness. The child has pneumonia, and the parents are not always anxious to stop taking the medicine. The clinical cooperation is relatively good. If the child is treated with intravenous antibiotics, and it is particularly difficult for the child to apply intravenous antibiotics, some parents will ask the doctor if they can change to oral antibiotics. In case of severe pneumonia, intravenous antibiotics are recommended, but intravenous infusion is not necessary throughout the course of treatment. When the child's temperature is controlled and the cough symptoms are relieved, oral antibiotics can be considered to complete the course of treatment.
The diagnosis of pneumonia needs to be determined by doctors according to symptoms, signs, tests and chest films. Parents do not need to learn how to diagnose pneumonia, as long as they know that these conditions may be pneumonia: when the newborn is mentally weak and has little milk; The baby coughs, chokes and vomits milk, shortness of breath or dyspnea, irritability or malaise; Children and older children have severe cough accompanied by high fever, especially when coughing for the first time. The possibility of pneumonia should be considered when high fever occurs with the aggravation of cough, which is an indication for medical treatment.
——This article is excerpted from the book "Baby Don't panic when sick" authorized by Free Oriental Publishing House
