Hello,
Thank you for your query at DoctorSpring.com
I can understand your situation. You are obviously going through a lot right now.
Based on your description of his symptomatology, Justin is either having an 'ACUTE EXACERBATION of his ASTHMA' or a really bad 'Upper respiratory tract infection'. The fact that he does not have any fever points more to the first diagnosis.
Let us take it one step at a time:
STEP 1: If Justin is having any difficulty breathing or chest wall retractions/indrawing or significant 'wheeze' or is breathing too fast (You can count it yourself' Look at the movement of the chest wall for one full minute. If it is more than 40 breaths/min, it is too fast). If any of the above mentioned problems exist, then you should take him to the nearest pediatric emergency facility (obviously, with adequate protection from the inclement weather).
STEP 2: If he is not having any of the above, you could try home-based symptomatic therapy. You could use cough syrup to provide him with symptomatic relief. Using ALBUTEROL every 3 hours is not the RIGHT thing to do. In case of an acute exacerbation of asthma, he would require inhaled/systemic steroid therapy as well. If you have a budesonide inhaler, you could administer a couple of puffs of the same at home. You could also try using steam inhalation to open up his blocked nose and make Justin feel a bit more comfortable. But, it may not work in all children and is only a symptomatic measure.
Steps to using a 'METERED DOSE INHALER with spacer with mask' is available as a video on youtube and a videographer depiction may help you understand the technique better.
Note: The quivering that you describe is a SIDE-EFFECT of Beta-2 against therapy ( albuterol). It may not necessarily be indicative of the child being cold. Again the quivering could also be due to an overdose of albuterol (As you have been using it 3 hourly). You need to check Justin into your local hospital, if the quivering persists.
The treatment of an acute exacerbation of asthma after the first few hours is essentially hospital based with use of IV drugs and it is important not to unduly delay the administration of appropriate therapy.
Wishing Justin a speedy recovery.
Dr. Saptharishi L G
Pediatric Emergency Medicine Expert