Asthma by yaofenjin



                                       Together We CAN
                                      Control Asthma Now

Major funding for our program provided in part by:      and the Miller Foundation
What is Asthma?
 A chronic (long-term) condition of the
 A condition that cannot be cured, but can
  be controlled
 A condition that tends to run in families-
  not contagious
 A condition that children do not out-grow
  (some children just aren’t bothered as much
  by their Asthma as they grow up)
What happens in your lungs during an
Asthma attack?

1. Tightening (constriction) of the muscles around
    the airways making them smaller.
2. Swelling (inflammation ) of the muscles of the
3. Too much mucus is produced in the airways
These three things make it difficult to breathe!
What are common Asthma signs?

  The number of possible Asthma signs and
  their severity vary from child to child and
  even from Asthma attack to Asthma attack.
    What are Early Asthma Warning

     These clues tell you an Asthma attack is
     about to begin. The most common are:
    Coughing
    Scratchy throat/chin
    Moodiness/Irritability
    Runny Nose or itchy eyes
    Ear ache
What are Common signs & symptoms of
   Coughing (day, night, or with exercise)
   Difficulty breathing/Shortness of breath
   Wheezing (a whistling noise)
   Chest tightness
   Trouble sleeping/ waking at night
   Not able to exercise or have normal activity
   Low peak flow meter reading
What are Symptoms of Severe Asthma or
an attack?
 When medication (Albuterol) doesn’t alleviate
          signs above and they worsen!
 Extreme difficulty breathing
 Difficulty walking and talking
 Trouble catching your breath- even when
 Severe chest tightness
 Uncontrolled coughing
     What do I do in an Asthma Emergency?
        In an Asthma emergency, the signs are very clear! It is
       important to recognize emergency signs (mentioned earlier)
                        and ACT QUICKLY.
      ACTION PLAN(Red Zone)
 Does every child have the same degree of
 Even though every child’s Asthma is different, how often their
        signs or symptoms happen can fit into one of these
                    categories (levels of severity):
 Intermittent Asthma= there are day symptoms twice a
   week or less and/or night symptoms twice a month or less
 Persistent Asthma= there are day symptoms more than
   twice a week or wake up with symptoms during the night
   more than twice a month
 Medications prescribed are based on the severity of the
   child’s Asthma.
What is the difference between the two types of
Asthma medication?
        Quick-Relief (Rescue) Medication =
              Bronchodilator= Albuterol
   Opens the airways fast to stop an Asthma attack once
    there are warning signs
    Is taken when the child has symptoms
    Can be taken every 4-6 hours as needed (you can see
    improvement with this medication within the first 5- 10
    minutes if it’s working)
    Is taken 10-15 minutes before exercise, only if prescribed
What is the difference between the two types of
Asthma medication? (continued)
           Long-Term Control Medication =
     Works long-term, decreasing swelling and mucus build-
      up in the airways
      For persistent Asthma to prevent attacks
      Must be taken everyday even when there are no Asthma
      Keeps the right amount of medicine in the body at all
      Usually takes a few weeks before effects are felt
Why do people need Asthma medications?

1. To keep their Asthma under control on a daily
2. As quick-relief medicine when Asthma symptoms
   start or to help keep an Asthma attack from
   getting worse
3. As a tool before beginning intense physical activity
   or exposure to another known trigger
    How do I know when I need to refill my
    Your provider will help you determine when your
     medicine needs to be refilled based on how frequently
     you have to take it.
     The number of “Puffs” or Metered Actuations
     available in an inhaler is written on the inhaler (the
     Diskus actually has a counter that counts down.)
     Call your provider if you have any questions and make
     sure to go to each scheduled appointment! Take with
     you medications and a list with any questions you have
     for your doctor.
  What are some of the common side-effects?

 Children should experience few to no side effects from
       their Asthma medication when taken properly.

* Reported possible side effects include:
   nervousness/restlessness, hyperactivity, heart
    Asthma Gadgets
   Asthma medications can only be beneficial if taken accurately
    (when directed/ as directed)
    Proper handling and technique when using Asthma gadgets
    insures appropriate delivery of medicines into the airways
    Even though Asthma medications can be given in different
    ways- it could still be potentially the same medicine (for example:
    Albuterol through an inhaler vs. nebulizer is still the same medicine!!).
    It is important to know what each of the medicines you are
    giving are and pay attention to how you are giving them (What
    gadgets are you using and when!)
1.    Stand or sit up straight
2.    Shake the inhaler (vigorously for 2 seconds or 10 shakes)
3.    Hold the inhaler 2-3 finger widths from your wide-open mouth
4.    Breathe out all the way
5.    Press inhaler once at the same time you begin to slowly inhale
6.    Once the lungs are fully inflated, hold your breath for a count of
      10 or longer
7.    Slowly exhale through your mouth
8.    For inhaled quick-relief medicine, wait 60 seconds
9.    Repeat steps 3-7 for puff two
10.   Rinse mouth after use
    MDI/ Spacer without a Mask
    Stand or sit up very straight
    Shake the inhaler (vigorously for 2 seconds or 10 shakes)
    Place the inhaler into the opening in the back of the spacer
    Make sure the child’s mouth entirely covers the mouthpiece
    Press inhaler once
    Have the child breathe deeply and slowly
    Have the child hold his/her breath for 8-10 seconds, remove
     the spacer and breathe slowly
    Wait 60 seconds
    Repeat steps 3-7 for puff two
    Rinse mouth after use
      MDI/ Spacer with Mask
1.     Stand or sit up very straight
2.     Shake the inhaler (vigorously for 2 seconds or 10 shakes)
3.     Place the inhaler into the opening in the back of the spacer
4.     Place the mask around the child’s face, making sure that both
       their nose and mouth are covered
5.     Press inhaler once
6.     Wait for 5-6 breaths
7.     Remove spacer with mask
8.     Wait 60 seconds
9.     Repeat steps 3-6 for puff two
10.    Rinse mouth after use.

1.     Twist open top of the unit dose vial and squeeze
      contents into nebulizer cup
2.    Attach mouthpiece or mask to nebulizer (it is better
      that children older than 2 use the mouthpiece)
3.     Connect nebulizer to machine
4.     Place mouthpiece in the child’s mouth /mask on the
      child and turn on machine
5.     Breathe slowly and deeply (5-15 minutes) until no
      more mist is formed
1.    Breathe out to clear your airways
2.    Open the diskus and stand up straight
3.    Pull back the leverage to engage the medicine and you will
      hear a click-make sure that you keep the diskus
      horizontal or else the medicine will spill out!
4.    Put your mouth entirely around the opening of the diskus
5.    Breathe in deeply and slowly
6.    Hold breath for 8 seconds
7.    Breathe out slowly
8.    Rinse mouth afterwards
     Peak Flow Meter
1.     Standing straight with chin tilted up, blow out to clear the
2.    Put the gauge on the meter to zero or towards the bottom of
      the numbered scale
3.    Take a deep breath in
4.    Blow out into the mouthpiece as hard and fast as you can in a
      single blow (*seal lips around the mouthpiece!)
5.    Read the number (tell mom to write it down on a paper)
6.    Repeat steps 1-5 two more times
7.    Write the biggest number achieved from the peak flow meter
      in your logbook
    What is an Asthma Action Plan?

     A written plan made for each child and their family
     (copies are given to caregivers and schools)
    Goal is to help a child and their family manage or
     control Asthma and know what do if their Asthma
     gets worse
    Based on Asthma signs and peak flow numbers
    Gives information on Asthma medication schedules,
     what to do in different situations, and when it is time
     to go to the clinic or emergency room
    Asthma Action Plan (continued)
    GREEN means Go: Asthma is under control or there are
     no signs or symptoms! Continue all medicines in the green
     zone since these are the long term control medicines

    YELLOW means Slow Down- Caution: Asthma signs are
     starting! Take the quick-relief (rescue) medicine and follow
     directions on the Asthma Action Plan. Note: It is important
     to continue taking the medicine in the Green zone.

    RED means Stop- Medical Alert: This Asthma Attack is
     serious, take the quick-relief medicine, follow your plan for
     severe attacks and go to the clinic or emergency room NOW!
What are Asthma Triggers and what are the most
common ones?
Asthma triggers are things may bother the airways, making it hard to breathe
resulting in Asthma signs. The most common are:

Allergies to:
        Pets/dander – protein found on the saliva and skin of furry animals
        Mold – tiny spores which grow in damp places
        Dust/Dust mites – live in mattresses, pillows, carpets, fabric
         furniture, bedcovers, or stuffed toys
        Pollen – grass, trees, plants, and weeds
        Pests – cockroaches and mice – their droppings become dust-like and
         are breathed in
        Certain Foods – like milk and eggs
  What are Asthma Triggers and what are the most
  common ones? (continued)

Colds     and the flu
 Certain untreated medical conditions- sinus infections (sinusitis),
  allergies (allergic rhinitis) or gastro esophageal reflux
 Exercise
 Changes in weather
 Strong emotions – bursts of laughter, tantrums
 Strong odors - perfume, hair spray, wet paint, cleaning products
 Pollution
Medication (aspirin)
What are the main ways to reduce environmental
exposure to known Asthma triggers?
     Smoking: Try to quit; do not smoke in your home; do
      not allow others to smoke in your home
      Pets/ Dander: Keep outdoors or give them another
      home; keep them out of the child’s room at all times,
      including keeping the child’s bedroom door closed; keep
      off furniture
      Mold: Keep areas dry; wash mold off right away and
      make sure it is completely dry; keep windows open when
      showering, using the dishwasher or cooking; clean with
      10% chlorine bleach solution (1 part Cl/9 parts H20); fix
      or report leaks and water damage
What are the main ways to reduce environmental
exposure to known Asthma triggers? (continued)
     Dust: Clean with a damp cloth; vacuum with windows
      open and when the child is not around; dust and vacuum
      often; remove carpets if possible

     Dust Mites: Wash sheets and blankets once a week in
      hot water; use 100% cotton blankets; cover mattress and
      pillow in dust-mite proof covers; keep stuffed animals
      off bed and make sure they are washable; use blinds rater
      than curtains; remove clutter; make sure there is proper
      ventilation (clean filters)
What are the main ways to reduce environmental
exposure to known Asthma triggers? (continued)
     Pests: Keep all food in airtight containers; do not leave
      food out overnight; clean countertops every night; if a
      problem, use Boric Acid- thin dusting in areas where they
      gather and enter-along linear areas (baseboards, etc.)
      Untreated Medical Conditions: See the doctor
      whenever you think you may have an upper respiratory
      infection and take all medicines as prescribed
      Air Pollution: Exercise in the morning; don’t do
      strenuous exercise on poor air quality days or close to
What are your provider’s responsibilities?
    Explain what asthma is and the goals of therapy
    Explain types of medications and how they work and how to take
    Assess asthma severity at each visit and change medications if
     Fill-out asthma action plan for patient and explain how to respond
     to changes in severity
     Identify possible asthma triggers and how to avoid or eliminate
    Explain how to manage asthma at school/after-school/childcare
    Partner with you, the patient, to control asthma!
    What are your responsibilities?
   Ask questions about any information that you are unsure of
   Take all medications as prescribed- every time!
   Notify provider of any changes in symptoms, if there are any side-effects or
    to refill medicines
   Follow your asthma action plan
   Call the doctor if your asthma is not under control
   Bring asthma medications to each appointment
   Write down questions and concerns that you want to ask the doctor so you
    don’t forget to ask him/her
   Go to all scheduled appointments even if you are feeling well!
   Partner with your provider to control your asthma!
    Ways to Know Your Asthma is Under
    Control/Goals of Asthma Management
   You know your Asthma signs and triggers
   You go through the day with no Asthma signs
   You sleep through the night and wake up in the morning with
    no Asthma signs
   You can walk, run and play hard with your friends and are not
    bothered by your Asthma
   You can play the sports that you want and your Asthma
    doesn’t start up
   You have not missed school because of your Asthma
   You have not gone to the emergency room because of your
   You have not been in the hospital because of your Asthma

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