Asthma Caring for children with asthma in a community program

Asthma Airways that are `hyperresponsive` to environmental factors Increased mucus production Tightened airway muscles

Signs of Asthma Coughing Wheezing Chest tightness Shortness of breath Increase in breathing rate

Causes of Asthma Genetics Environment

Triggers of Asthma Inflammatory Respiratory infections Animal dander Dust mites Mold Pollens Tobacco smoke Symptom Cold, dry air Smoke Strong odors Air pollution Exercise Emotions Stress

Treatment of Asthma Signs of good control – normal activity – normal sleep – no daytime asthma symptoms – no need for reliever medication – no emergency room visits – no absentees for asthma

Avoidance of Triggers Some triggers are more common at certain times Cold and flu Outdoor molds Pollens Exercise Field trips

Avoidance Strategies Paint, varnish and tar when children not present Keep windows closed during pollen and mold seasons Restrict pets with hair, fur, feathers Clean equipment regularly to avoid accumulation of dust Prohibit smoking in the facility Avoid wearing perfumed products Choose cleaning solutions that do not have a strong odor Encourage children to wear a scarf over their mouth when exercising outdoors in winter

Medications Controllers Relievers

Controllers Also called ‘preventers’ or anti- inflammatory medication Control asthma by reducing airway swelling and mucus production Prevent or decrease asthma symptoms Most often taken at home

Relievers Also call ‘bronchodilators’ Provide fast temporary relief from asthma symptoms by relaxing muscles around the airways Should be with child for easy access May be used to prevent exercise induced asthma Blue coloring on cap

Medication Devices Turbuhaler ® Metered Dose Inhaler

1.Remove cap. 2.Shake well. 3.Have child breathe out as completely as possible. 4.Bring inhaler to child’s mouth. 5.Push down on canister once as child breathes in. 6.Have child inhale slowly & deeply. 7.Replace cap.

Turbuhaler ® 1.Remove cap. Do NOT shake. 2.Hold Turbuhaler® upright. 3.Turn colored grip in one direction and then back. 4.Have child breathe out. 5.Place Turbuhaler® mouthpiece between the child’s lips and have the child quickly breathe in. 6.Remove Turbuhaler® from the child’s mouth and have child hold breath. 7.Have the child breathe out. 8.Replace cap.

Spacer Devices

AeroChamber ® 1.Shake MDI and remove its cap. 2.Remove AeroChamber® cap and insert MDI. 3.Place AeroChamber® in child’s mouth. 4.Have child breathe out. 5.Push down once on MDI canister. 6.Have child inhale and hold breath for 10 seconds OR breathe normally 5-6 times. 7.Replace caps.

AeroChamber ® with Mask 1.Shake MDI and remove its cap. 2.Insert MDI into AeroChamber®. 3.Apply mask to child’s face. 4.Have child breathe out. 5.Push down once on canister. 6.Have child inhale deeply and hold OR breathe normally 5-6 times. 7.Replace cap.

Asthma symptoms prevent the child from performing normal activities Frequent coughing, shortness of breath, wheezing Child is using reliever medication more than 3 times per week for symptoms or with exercise When Asthma is Not Controlled Inform parent/guardian.

When a Child has an Asthma Episode 1.Remove child from triggers. 2.Have child sit down. 3.Ensure child takes reliever medication. 4.Encourage slow deep breathing. 5.Monitor child for improvement.

Emergency Situations Reliever medication has been given and there is no improvement of asthma symptoms in five minutes Greyish/bluish color in lips and nail beds Inability to speak in full sentences Heaving of chest or chest sucking inward Shoulders held high, tight neck muscles Cannot stop coughing Difficulty walking

Emergency Response Plan 1.Activate 911/EMS. 2.Give reliever medication every five minutes. 3.Notify parent/guardian. 4.Stay with child until EMS personnel arrives.

Child specific information Name and location of reliever medication Type of medication device used Assistance required, if any Health Care Plans are located in child file and binder