AsthmaCaring for children

with asthma in a community program

2014-05-21

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

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