Asthma is a major noncommunicable disease (NCD), affecting both children and adults, and is the most common chronic disease among children. Asthma can cause slight inconveniences or serious problems that interfere with day-to-day activities and can even result in a potentially fatal asthma attack. This presentation gives an overview on how to Control asthma, including: causes, symptoms, management, prevention, and treatment. For more information, please contact us: 9779030507.
1) The document provides an overview of asthma including its definition, prevalence, pathophysiology, diagnosis, management, and treatment guidelines.
2) Key points include that asthma is a chronic inflammatory airway disease, over 2 million Canadians have asthma, and control is possible through daily controller medications and lifestyle modifications.
3) Treatment involves long-term control with inhaled corticosteroids and bronchodilators, along with managing triggers and exacerbations according to a written asthma action plan. The goal is to achieve total control of symptoms and maintain normal lung function and activity levels.
Asthma is a major health problem in the US, affecting 5 million school-aged children. It causes students to miss nearly 13 million school days per year. The presentation provides an overview of asthma, including its causes, symptoms, triggers, impact on learning, and how it can be controlled. It also discusses how to create asthma-friendly schools and handle asthma episodes.
This document discusses asthma in children. It defines asthma as a chronic lung disease that causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing due to inflammation and narrowing of the airways. It notes that while the exact cause is unknown, environmental exposures and genetic factors likely play a role. It describes the types, symptoms, diagnosis, and treatment of childhood asthma, including the use of quick-relief medications and long-term control medications to manage symptoms and reduce inflammation. It also discusses reviewing treatment response, adjusting medications, and the generally poor prognosis for complete remission of childhood asthma.
This document discusses challenges in diagnosing and managing asthma. It addresses managing the diagnosis, the patient's mindset, treatment, and non-adherence. Regarding diagnosis, it emphasizes listening to patients, using models to explain inflammation, and observing children at rest and exercise. Managing the patient's mind involves addressing denial of the condition and concerns about medications. Treatment focuses on the advantages of inhaled therapies over oral medications. Non-adherence can be addressed through once-daily dosing, using peak flow meters, and taking comorbidities seriously. The difficult asthmatic may just need re-education on airway structure and treatment.
bronchialasthma in children treatment.pptxssuser90ffff
Bronchial asthma in children is a chronic inflammatory disease of the airways characterized by episodic and/or chronic airway obstruction symptoms that are at least partially reversible. It has both environmental and genetic risk factors and most cases onset before age 6. There are three main types - early childhood viral-induced wheezing, allergy-induced chronic asthma, and obesity-associated asthma in females. Treatment involves assessment, education, trigger avoidance, and medications to reduce inflammation and bronchoconstriction including inhaled corticosteroids, bronchodilators, and leukotriene modifiers.
Asthma is a disease affecting the airways that carry air to and from your lungs. People who suffer from this chronic condition (long-lasting or recurrent) are said to be asthmatic.
Asthma is a chronic inflammatory disorder of the airways that causes recurring episodes of wheezing, breathlessness, chest tightness and coughing. It affects people of all ages and its prevalence is increasing worldwide. Asthma can be diagnosed based on symptoms and medical history and confirmed through lung function tests. Effective asthma management requires a partnership between the patient and doctor to control symptoms, identify and reduce risk factors, treat exacerbations, and monitor the condition.
Pediatric Chronic Disease Case ManagementAshley Poston
This document provides information about asthma case management programs in Alameda County, California. It reports that 19.6% of children in Alameda County have asthma, one of the highest rates in California. Two key programs are described: the Northern California Breathmobile, which provides mobile asthma services, and the Asthma Start Program run by the Alameda County Public Health Department. Both programs aim to reduce emergency visits and hospitalizations from asthma. The document also outlines national and local standards and goals for asthma case management, treatment, education components, and outcomes of the programs.
1) The document provides an overview of asthma including its definition, prevalence, pathophysiology, diagnosis, management, and treatment guidelines.
2) Key points include that asthma is a chronic inflammatory airway disease, over 2 million Canadians have asthma, and control is possible through daily controller medications and lifestyle modifications.
3) Treatment involves long-term control with inhaled corticosteroids and bronchodilators, along with managing triggers and exacerbations according to a written asthma action plan. The goal is to achieve total control of symptoms and maintain normal lung function and activity levels.
Asthma is a major health problem in the US, affecting 5 million school-aged children. It causes students to miss nearly 13 million school days per year. The presentation provides an overview of asthma, including its causes, symptoms, triggers, impact on learning, and how it can be controlled. It also discusses how to create asthma-friendly schools and handle asthma episodes.
This document discusses asthma in children. It defines asthma as a chronic lung disease that causes recurring periods of wheezing, chest tightness, shortness of breath, and coughing due to inflammation and narrowing of the airways. It notes that while the exact cause is unknown, environmental exposures and genetic factors likely play a role. It describes the types, symptoms, diagnosis, and treatment of childhood asthma, including the use of quick-relief medications and long-term control medications to manage symptoms and reduce inflammation. It also discusses reviewing treatment response, adjusting medications, and the generally poor prognosis for complete remission of childhood asthma.
This document discusses challenges in diagnosing and managing asthma. It addresses managing the diagnosis, the patient's mindset, treatment, and non-adherence. Regarding diagnosis, it emphasizes listening to patients, using models to explain inflammation, and observing children at rest and exercise. Managing the patient's mind involves addressing denial of the condition and concerns about medications. Treatment focuses on the advantages of inhaled therapies over oral medications. Non-adherence can be addressed through once-daily dosing, using peak flow meters, and taking comorbidities seriously. The difficult asthmatic may just need re-education on airway structure and treatment.
bronchialasthma in children treatment.pptxssuser90ffff
Bronchial asthma in children is a chronic inflammatory disease of the airways characterized by episodic and/or chronic airway obstruction symptoms that are at least partially reversible. It has both environmental and genetic risk factors and most cases onset before age 6. There are three main types - early childhood viral-induced wheezing, allergy-induced chronic asthma, and obesity-associated asthma in females. Treatment involves assessment, education, trigger avoidance, and medications to reduce inflammation and bronchoconstriction including inhaled corticosteroids, bronchodilators, and leukotriene modifiers.
Asthma is a disease affecting the airways that carry air to and from your lungs. People who suffer from this chronic condition (long-lasting or recurrent) are said to be asthmatic.
Asthma is a chronic inflammatory disorder of the airways that causes recurring episodes of wheezing, breathlessness, chest tightness and coughing. It affects people of all ages and its prevalence is increasing worldwide. Asthma can be diagnosed based on symptoms and medical history and confirmed through lung function tests. Effective asthma management requires a partnership between the patient and doctor to control symptoms, identify and reduce risk factors, treat exacerbations, and monitor the condition.
Pediatric Chronic Disease Case ManagementAshley Poston
This document provides information about asthma case management programs in Alameda County, California. It reports that 19.6% of children in Alameda County have asthma, one of the highest rates in California. Two key programs are described: the Northern California Breathmobile, which provides mobile asthma services, and the Asthma Start Program run by the Alameda County Public Health Department. Both programs aim to reduce emergency visits and hospitalizations from asthma. The document also outlines national and local standards and goals for asthma case management, treatment, education components, and outcomes of the programs.
Asthma is a common chronic disease, especially in children under 18, with over 23 million Americans affected. The majority of children with asthma develop symptoms by age 4-5. Common symptoms include coughing, wheezing, difficulty breathing, chest tightness and pain. If properly managed with medications and avoiding triggers, asthma flares can be prevented. While the exact cause is unknown, genetics and allergies may play a role in increased risk.
This presentation summarizes key information about asthma. It discusses how asthma is a chronic lung condition characterized by inflammation and constriction of the bronchioles. Symptoms include coughing, wheezing, chest tightness and shortness of breath. Asthma has no cure but can be managed through medications and by avoiding triggers such as allergens, infections and air pollution. The presentation outlines different types of asthma medications and strategies for controlling asthma symptoms and flare-ups.
This document provides information for parents about childhood asthma. It explains that asthma is a chronic lung condition characterized by airway inflammation and constriction in response to triggers. Common triggers include allergens like dust, pollen, pets and smoke. It advises parents on ways to identify asthma symptoms, manage triggers through cleaning and avoiding allergens, and treat asthma attacks. Parents are encouraged to work closely with their child's doctor to properly diagnose and manage their child's asthma.
AWARENESS FOR ASTHMA - TO MAKE PEOPLE AWARE OF ASTHMAshivamverma345
1) Asthma is a long-term condition where airways become narrow, causing breathing difficulties. This is caused by swelling, tightening of muscles, and excess mucus in the airways.
2) Common asthma triggers include allergens, tobacco smoke, chemicals and infections. Symptoms include coughing, wheezing, chest tightness and fatigue.
3) Medications include reliever medicines for acute attacks and controller medicines for long-term control. Inhalers and nebulizers are common delivery methods.
Schools should identify asthmatic students, educate staff on symptoms and treatments, and have emergency plans and kits in place to quickly respond to asthma attacks.
Asthma is a chronic disease that causes temporary narrowing of the airways, making breathing difficult. It is the primary reason children miss school and most common cause of emergency room visits. As an educator, it is important to understand asthma so you can help children follow their Asthma Action Plans. Asthma can be triggered by allergens, exercise, infections, smoke, chemicals and more. While incurable, asthma can be controlled through proper diagnosis, communication between parents and doctors, monitoring symptoms, and daily preventative medications along with quick relief medications during attacks. Seeking emergency help is important if symptoms worsen or quick relief does not help.
Asthma is a chronic disease that causes temporary narrowing of the airways, making breathing difficult. It is the primary reason children miss school and most common cause of emergency room visits. As an educator, it is important to understand asthma so you can help children follow their Asthma Action Plans. Asthma can be triggered by allergens, exercise, infections, smoke, chemicals and more. While incurable, asthma can be controlled through proper diagnosis, communication between parents and doctors, monitoring symptoms, and treatments like inhalers and medications. Seeking emergency help is important if symptoms worsen or quick relief does not work.
The document provides information about managing childhood asthma, including what asthma is, common asthma triggers, different types of asthma medicines and how to use them properly, how to recognize and treat asthma attacks, and resources for managing asthma. It was created by the Children's Health Fund to educate families on controlling childhood asthma through understanding the condition and using appropriate treatment plans and medications. The guide emphasizes that with proper management, children can participate in normal activities despite having asthma.
Every allergic reaction has the potential to develop into a life-threatening anaphylactic reaction within minutes of exposure to an allergen. Food allergy and asthma prevalence in children has increased significantly in recent years, putting more students at risk. Schools must be prepared to recognize symptoms of allergic reactions, administer emergency medication like epinephrine promptly according to individualized plans, and contact emergency services immediately.
1) The document discusses how asthma management can provide great opportunities for family doctors and general practitioners to treat patients and grow their practices. Asthma is very common, affecting 1 in 10 patients, and most patients prefer treatment from their family doctor over a chest physician.
2) The key to a successful asthma practice is proper diagnosis, treatment, simplifying the treatment plan for patients, and effective communication. Proper diagnosis can usually be made with a focused history and examination. Treatment involves both reliever and controller medications, with inhaled corticosteroids being the most effective controller.
3) With the right approach, family doctors can treat asthma as effectively as chest physicians. Regular use of inhaled corticosteroids
The document discusses asthma, including its symptoms, triggers, diagnosis, treatment, management, effects, and resources. It describes how asthma is caused by inflammation and narrowing of the airways. It outlines common allergic and non-allergic triggers, methods of diagnosis using peak flow meters, and typical treatments including inhalers and avoiding triggers. It also addresses asthma management plans, the impact of asthma on schools and children's activity levels, and resources for further information.
Dr. Chrishana Ogilvie-McDaniel of Via Christi Clinic discusses pediatric asthma and allergy: the Back-To-School Edition of pediatric allergy and immunology.
This document provides information and guidance on preventing and responding to allergic reactions in school settings. It defines common food and other allergens, signs and symptoms of allergic reactions, and steps for prevention, recognition, and emergency response. Key points include that avoidance of allergens is key to prevention, and that epinephrine is the first-line treatment for anaphylaxis. It emphasizes the importance of having care plans and medications available, and training staff on their use.
This document provides an overview of asthma including its incidence, etiology, pathophysiology, clinical manifestations, diagnosis, and management. Some key points:
- Asthma prevalence has increased 61% over the last two decades and it is the leading chronic illness among children.
- It is caused by airway inflammation and obstruction from factors such as allergens, infections, pollutants, and psychosocial stress.
- Symptoms include dyspnea, wheezing, and cough. Diagnosis involves patient history, physical exam, and sometimes chest X-rays.
- Treatment involves quick-relief medications for acute attacks, long-term preventers to control inflammation, and patient education on trigger avoidance and proper
This document provides an overview of asthma including its incidence, etiology, pathophysiology, clinical manifestations, diagnosis, and management. Some key points:
- Asthma prevalence has increased 61% over the last two decades and it is the leading chronic illness among children.
- It is caused by airway inflammation and obstruction from factors such as allergens, infections, pollutants, and psychosocial stress.
- Symptoms include dyspnea, wheezing, and cough. Diagnosis involves patient history, physical exam, and sometimes chest X-rays.
- Treatment involves quick relievers for acute attacks, preventers to control inflammation, and environmental control/patient education. Nursing care focuses on education
This document provides guidance on assessing and managing pediatric respiratory emergencies. It defines respiratory distress, failure, and arrest and outlines how to use the Pediatric Assessment Triangle (PAT) including examining the child's appearance, work of breathing, and circulation. Specific conditions discussed include croup, epiglottitis, foreign body aspiration, asthma, and bronchiolitis. Treatment recommendations are provided for different severity levels. The document stresses the importance of proper assessment to determine if a child needs on-scene treatment or rapid transport to definitive care.
Bronchial asthma in children is a chronic respiratory disease characterized by recurrent episodes of wheezing, coughing, and shortness of breath. It is caused by a complex interplay of genetic and environmental factors that lead to inflammation and narrowing of the airways. Symptoms are typically treated based on their severity with inhaled corticosteroids and bronchodilators as controller and rescue medications respectively.
Asthma is a chronic inflammatory disease of the airways characterized by episodic obstruction, bronchial hyperresponsiveness, and reversibility of airflow obstruction. It affects 9.6 million US children and is more common in boys, children in poor families, and those with onset before age 6. Treatment involves assessment, education, trigger identification, and medications to reduce inflammation and bronchoconstriction. The goal is optimal asthma control through a stepwise treatment approach based on severity. Prognosis depends on severity, with milder cases often improving over time. Prevention focuses on avoiding tobacco smoke, prolonged breastfeeding, active lifestyles, and immunizations.
This document provides information on bronchial asthma in children, including its definition, clinical manifestations, management, and nursing care. Asthma is a chronic inflammatory airway disease characterized by wheezing, breathlessness, and chest tightness. It most often develops in early childhood. Treatment involves controlling allergens, using long-term preventative medications and quick-relief rescue medications, and managing acute exacerbations. Nursing care focuses on respiratory assessment, providing emotional support, administering fluids, and educating patients and families.
Asthma is a chronic inflammatory disorder of the airways that causes intermittent and recurrent episodes of wheezing, shortness of breath, chest tightness and coughing. It affects over 17 million Americans and is a leading cause of school absences. While it has no cure, symptoms can be controlled through environmental trigger avoidance and medication management. Proper asthma care involves education, monitoring, controlling triggers and following treatment plans.
Therapeutic Plasma Exchange (TPE) is a procedure where a patient's blood is filtered through an apheresis machine, with red blood cells reinfused and replacement fluid like plasma or albumin added to the patient. This presentation gives an overview on "Therapeutic Plasma E xchange". For more information please contact us: 9779030507.
Asthma is a common chronic disease, especially in children under 18, with over 23 million Americans affected. The majority of children with asthma develop symptoms by age 4-5. Common symptoms include coughing, wheezing, difficulty breathing, chest tightness and pain. If properly managed with medications and avoiding triggers, asthma flares can be prevented. While the exact cause is unknown, genetics and allergies may play a role in increased risk.
This presentation summarizes key information about asthma. It discusses how asthma is a chronic lung condition characterized by inflammation and constriction of the bronchioles. Symptoms include coughing, wheezing, chest tightness and shortness of breath. Asthma has no cure but can be managed through medications and by avoiding triggers such as allergens, infections and air pollution. The presentation outlines different types of asthma medications and strategies for controlling asthma symptoms and flare-ups.
This document provides information for parents about childhood asthma. It explains that asthma is a chronic lung condition characterized by airway inflammation and constriction in response to triggers. Common triggers include allergens like dust, pollen, pets and smoke. It advises parents on ways to identify asthma symptoms, manage triggers through cleaning and avoiding allergens, and treat asthma attacks. Parents are encouraged to work closely with their child's doctor to properly diagnose and manage their child's asthma.
AWARENESS FOR ASTHMA - TO MAKE PEOPLE AWARE OF ASTHMAshivamverma345
1) Asthma is a long-term condition where airways become narrow, causing breathing difficulties. This is caused by swelling, tightening of muscles, and excess mucus in the airways.
2) Common asthma triggers include allergens, tobacco smoke, chemicals and infections. Symptoms include coughing, wheezing, chest tightness and fatigue.
3) Medications include reliever medicines for acute attacks and controller medicines for long-term control. Inhalers and nebulizers are common delivery methods.
Schools should identify asthmatic students, educate staff on symptoms and treatments, and have emergency plans and kits in place to quickly respond to asthma attacks.
Asthma is a chronic disease that causes temporary narrowing of the airways, making breathing difficult. It is the primary reason children miss school and most common cause of emergency room visits. As an educator, it is important to understand asthma so you can help children follow their Asthma Action Plans. Asthma can be triggered by allergens, exercise, infections, smoke, chemicals and more. While incurable, asthma can be controlled through proper diagnosis, communication between parents and doctors, monitoring symptoms, and daily preventative medications along with quick relief medications during attacks. Seeking emergency help is important if symptoms worsen or quick relief does not help.
Asthma is a chronic disease that causes temporary narrowing of the airways, making breathing difficult. It is the primary reason children miss school and most common cause of emergency room visits. As an educator, it is important to understand asthma so you can help children follow their Asthma Action Plans. Asthma can be triggered by allergens, exercise, infections, smoke, chemicals and more. While incurable, asthma can be controlled through proper diagnosis, communication between parents and doctors, monitoring symptoms, and treatments like inhalers and medications. Seeking emergency help is important if symptoms worsen or quick relief does not work.
The document provides information about managing childhood asthma, including what asthma is, common asthma triggers, different types of asthma medicines and how to use them properly, how to recognize and treat asthma attacks, and resources for managing asthma. It was created by the Children's Health Fund to educate families on controlling childhood asthma through understanding the condition and using appropriate treatment plans and medications. The guide emphasizes that with proper management, children can participate in normal activities despite having asthma.
Every allergic reaction has the potential to develop into a life-threatening anaphylactic reaction within minutes of exposure to an allergen. Food allergy and asthma prevalence in children has increased significantly in recent years, putting more students at risk. Schools must be prepared to recognize symptoms of allergic reactions, administer emergency medication like epinephrine promptly according to individualized plans, and contact emergency services immediately.
1) The document discusses how asthma management can provide great opportunities for family doctors and general practitioners to treat patients and grow their practices. Asthma is very common, affecting 1 in 10 patients, and most patients prefer treatment from their family doctor over a chest physician.
2) The key to a successful asthma practice is proper diagnosis, treatment, simplifying the treatment plan for patients, and effective communication. Proper diagnosis can usually be made with a focused history and examination. Treatment involves both reliever and controller medications, with inhaled corticosteroids being the most effective controller.
3) With the right approach, family doctors can treat asthma as effectively as chest physicians. Regular use of inhaled corticosteroids
The document discusses asthma, including its symptoms, triggers, diagnosis, treatment, management, effects, and resources. It describes how asthma is caused by inflammation and narrowing of the airways. It outlines common allergic and non-allergic triggers, methods of diagnosis using peak flow meters, and typical treatments including inhalers and avoiding triggers. It also addresses asthma management plans, the impact of asthma on schools and children's activity levels, and resources for further information.
Dr. Chrishana Ogilvie-McDaniel of Via Christi Clinic discusses pediatric asthma and allergy: the Back-To-School Edition of pediatric allergy and immunology.
This document provides information and guidance on preventing and responding to allergic reactions in school settings. It defines common food and other allergens, signs and symptoms of allergic reactions, and steps for prevention, recognition, and emergency response. Key points include that avoidance of allergens is key to prevention, and that epinephrine is the first-line treatment for anaphylaxis. It emphasizes the importance of having care plans and medications available, and training staff on their use.
This document provides an overview of asthma including its incidence, etiology, pathophysiology, clinical manifestations, diagnosis, and management. Some key points:
- Asthma prevalence has increased 61% over the last two decades and it is the leading chronic illness among children.
- It is caused by airway inflammation and obstruction from factors such as allergens, infections, pollutants, and psychosocial stress.
- Symptoms include dyspnea, wheezing, and cough. Diagnosis involves patient history, physical exam, and sometimes chest X-rays.
- Treatment involves quick-relief medications for acute attacks, long-term preventers to control inflammation, and patient education on trigger avoidance and proper
This document provides an overview of asthma including its incidence, etiology, pathophysiology, clinical manifestations, diagnosis, and management. Some key points:
- Asthma prevalence has increased 61% over the last two decades and it is the leading chronic illness among children.
- It is caused by airway inflammation and obstruction from factors such as allergens, infections, pollutants, and psychosocial stress.
- Symptoms include dyspnea, wheezing, and cough. Diagnosis involves patient history, physical exam, and sometimes chest X-rays.
- Treatment involves quick relievers for acute attacks, preventers to control inflammation, and environmental control/patient education. Nursing care focuses on education
This document provides guidance on assessing and managing pediatric respiratory emergencies. It defines respiratory distress, failure, and arrest and outlines how to use the Pediatric Assessment Triangle (PAT) including examining the child's appearance, work of breathing, and circulation. Specific conditions discussed include croup, epiglottitis, foreign body aspiration, asthma, and bronchiolitis. Treatment recommendations are provided for different severity levels. The document stresses the importance of proper assessment to determine if a child needs on-scene treatment or rapid transport to definitive care.
Bronchial asthma in children is a chronic respiratory disease characterized by recurrent episodes of wheezing, coughing, and shortness of breath. It is caused by a complex interplay of genetic and environmental factors that lead to inflammation and narrowing of the airways. Symptoms are typically treated based on their severity with inhaled corticosteroids and bronchodilators as controller and rescue medications respectively.
Asthma is a chronic inflammatory disease of the airways characterized by episodic obstruction, bronchial hyperresponsiveness, and reversibility of airflow obstruction. It affects 9.6 million US children and is more common in boys, children in poor families, and those with onset before age 6. Treatment involves assessment, education, trigger identification, and medications to reduce inflammation and bronchoconstriction. The goal is optimal asthma control through a stepwise treatment approach based on severity. Prognosis depends on severity, with milder cases often improving over time. Prevention focuses on avoiding tobacco smoke, prolonged breastfeeding, active lifestyles, and immunizations.
This document provides information on bronchial asthma in children, including its definition, clinical manifestations, management, and nursing care. Asthma is a chronic inflammatory airway disease characterized by wheezing, breathlessness, and chest tightness. It most often develops in early childhood. Treatment involves controlling allergens, using long-term preventative medications and quick-relief rescue medications, and managing acute exacerbations. Nursing care focuses on respiratory assessment, providing emotional support, administering fluids, and educating patients and families.
Asthma is a chronic inflammatory disorder of the airways that causes intermittent and recurrent episodes of wheezing, shortness of breath, chest tightness and coughing. It affects over 17 million Americans and is a leading cause of school absences. While it has no cure, symptoms can be controlled through environmental trigger avoidance and medication management. Proper asthma care involves education, monitoring, controlling triggers and following treatment plans.
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Therapeutic Plasma Exchange (TPE) is a procedure where a patient's blood is filtered through an apheresis machine, with red blood cells reinfused and replacement fluid like plasma or albumin added to the patient. This presentation gives an overview on "Therapeutic Plasma E xchange". For more information please contact us: 9779030507.
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2. Is There A Cure For Asthma?
Asthma cannot be cured, but it can be Controlled
“We should expect nothing less”!
3. Goals Of Asthma Control
Prevent Symptoms
• No coughing or wheezing
• No shortness of breath or rapid breathing
• No waking up at night
Maintain normal or near “normal” pulmonary function
Maintain normal activity levels (including exercise and other physical activities
Prevent exacerbations of asthma and minimize ER/UC and hospital visits
Minimal or no adverse effects from medications
Meet patients/family’s expectations and satisfaction with asthma care
Exerts from NAEPP EPR2 Guidelines for Diagnosis and Management of Asthma 1997
5. Unfortunately NO!
Many students who have asthma:
• Have poor asthma control
• Use “quick relief” medicine (e.g. albuterol) on a regular basis
• Cough, experience chest tightness, wheezing, or shortness of breath
regularly
• Assume suffering from symptoms are “normal”
• Remain indoors and cannot fully participate in sports, PE or recess
• Miss school due to asthma
6. Examples Of Students Whose Asthma Is
NOT Optimally Controlled
• A 10th grader, says he feels fine except when he runs in PE class, then
his chest hurts. He coughs most mornings and whenever he gets a cold
or virus. He often can’t keep up with the other kids and needs to stop
and rest.
• A 12th grader, carries an OTC Primatine Mist inhaler & uses it a few
times every day. He says he “grew out” of his asthma.
7. Examples Of Students Whose Asthma
IS Optimally Controlled
• A 6th grader, doesn’t need his “reliever”(albuterol) since consistently using
his controller medications twice daily. He now plays soccer without
developing symptoms or having to take pre-exercise albuterol.
• A kindergartener, no longer coughs or wheezes and easily keeps up with the
other kids at recess. Her dad bought special dust mite proof covers for her
mattresses and pillow. She now takes her controllers daily, uses her Asthma
Action Plan, and sees her health care provider every 6 months for a well
asthma check-up.
8. Asthma Severity Level vs Asthma Control
Asthma Severity Levels (Mild Intermittent, Mild Persistent, Moderate
Persistent, and Severe Persistent)
Based on signs and symptoms before a student starts on controller
medications
Levels can change over time
Asthma Control (or “Current Asthma Severity”)
Is the students current severity level-
regardless if they are on medications, experiencing symptoms (episodes)
and/or able to be fully active
9. Asthma Control
Proactive vs Reactive
• Going from a reactive to a proactive approach
Instead of thinking-
“ How do I treat these symptoms?”
e.g. with albuterol after the fact
Think-
“ How could have the symptoms have been prevented in the first
place?”
e.g. daily controller medications, pre-exercise meds, asthma
action plan, environmental control
12. How To Achieve Good
Asthma Control
Have regular asthma check-ups with a primary healthcare provider, even when
feeling well
• At least every 6 months (more often if having symptoms)
Monitor symptoms and peak flow readings daily
Ask for and use a personalized Asthma Action Plan
Know personal green- yellow- red zones, what each zone feels like and what
to do in each zone
13. Asthma Control Continued...
Get a flu shot every fall
Avoid asthma triggers
Asthma’s not in control? Check in regularly at school health office for:
• Peak flow check /symptom evaluation
• Lung sounds / respiratory rate check
• Pre-exercise and/or controller meds
• Asthma education
• Care coordination
15. Written Asthma Action Plans
Developed by the health care provider for each individual child with asthma
Medications are determined by asthma severity level
Based on symptoms and peak flow rates
Lists daily & rescue medications
Symptom management and emergency plan
Copies to be shared by clinic, family and school
16. Asthma Action Plan Zones
Green Zone: All Clear/Breathing Good/Go
– No asthma symptoms and/or
– Peak flow 80-100% Predicted or Personal best
Yellow Zone: Caution/Slow Down
– Some asthma symptoms and/or
– Peak flow 50-80% Predicted or Personal best
Red Zone: Medical Alert/Stop
– Severe asthma symptoms and/or
– Peak flow < 50% Predicted or Personal best
17. What Can A Student Do To Stay In The Green Zone?
Select The Incorrect Answer
A. Take their controller (anti-inflammatory) medication every day
B. Avoid cigarette smoke and other asthma triggers
C. Take their pre-exercise (usually reliever) medicine before P.E. or at recess
D. Wash their bathroom often with bleach to avoid mold and mildew build-up
18. What Can A Student Do To Stay In The Green
one?
Select The Incorrect Answer
A.Take their controller (anti-inflammatory) medication every day
B. Avoid cigarette smoke and other asthma triggers
C. Take their pre-exercise (usually reliever) medicine before P.E.
or at recess
D. Wash their bathroom often with bleach to avoid mold and
mildew build-up
19. If A Student Is In The Yellow Zone,
They Should:
A.Be cautious. Breathing isn’t their best. Take action
B.Eat a lot of yellow foods such as bananas, which are high in
potassium
C.Automatically stay home from school
D.Call their doctor or nurse practitioner immediately
20. If A Student Is In The Yellow Zone,
They Should:
A. Be cautious. Breathing isn’t their best. Take action
B. Eat a lot of yellow foods such as bananas, which are high in potassium
C. Automatically stay home from school
D. Call their doctor or nurse practitioner immediately (correct answer:
call if they aren’t fully back into the green zone within 48-72 hours).
R1
21. Which Is One Symptom/ Clinical Indicator Is NOT
Associated With The Red Zone?
A. Mild coughing
B. Peak Flow reading < 50% of personal best
C. Significant breathing problems
D. Persistent wheezing or no wheezing at all indicating severely limited
aeration
22. Which Is One Symptom/ Clinical Indicator Is
Not Associated With the Red Zone?
A. Mild coughing
B. Peak Flow reading < 50% of personal best
C. Significant breathing problems
D. Persistent wheezing or no wheezing at all indicating severely limited
aeration
23. Activity
Group Case Discussion
The first month of school, you are called to an elementary school by a
substitute teacher. She sent a 3rd grader to the nurse’s office alone, and
told her to lay down.
When you arrive, child has neck vein distension, accessory muscle
retractions, dark/dusky color. No inhaler available
Mom is 45 min. away. Grandma is in town
WHAT DO YOU DO?
25. Common Environmental Triggers At Schools
• Indoor Triggers
Animals with fur
Dust mites
Mold
Pests
Secondhand smoke
Chemicals (e.g. strong
smelling cleaning supplies,
perfume, air fresheners)
• Outdoor Triggers
Ozone
Particulate matter
Diesel exhaust
Chemicals (e.g. re-
surfacing the playground or
roof, etc.)
26. Animals
• Dander, urine & saliva are triggers
• Triggers remain months after animal pet removed
• Actions:
Prohibit/remove animals from schools if able
If removal is not possible:
» Keep animals in cages or localized areas
» Clean cages often
» Keep animals away from fabric furniture, carpet & ventilation system
» Locate sensitive students away from animals
Pre-notify parents if animals with fur/feathers visit
• Sample Animals in School Guidelines in manual R1
27. Dust Mites
• Both cause & trigger asthma; live in pillows, carpet, fabric-covered furniture,
curtains
• Actions:
Keep classrooms clutter-free
Make informed decision: presence of carpet
Vacuum often when people with asthma/allergies are gone (HEPA filter
vacuum cleaners may help)
Pillows/mattress/box spring in dust-mite proof zipped covers
Wash bedding and stuffed toys weekly in HOT water (>130 degrees F)
Keep room humidity < 50% if possible
28. Mold
• Moisture control is key
• Actions:
Report leaks and wet/moist areas right away
Wash mold off hard surfaces
Replace moldy porous items such as ceiling tiles & carpet
Avoid carpet in areas with regular moisture such as drinking
fountains & sinks
E9
29. Pests
• Droppings or body parts can trigger asthma
• Actions:
Use integrated pest management (IPM) methods
» Don’t leave food, water or garbage exposed
» Don’t eat or drink in classroom
» Seal entry points for pests
» Use pesticides only as needed
Parent Right to Know Act: must notify parents & employees when
using specific pesticides
F32, F33, F34
30. Secondhand Smoke
• Causes asthma in young children & triggers asthma in children & adults
• Contains over 4,000 substances
• State law prohibits tobacco use in K-12 public schools
• Actions:
Enforce smoking bans (for anyone on school property)
Include anti-smoking message in curriculum
Encourage parents/guardians to quit smoking or to not smoke inside their
home
31. Outdoor Air
• Ozone & fine particles are concerns in MN
• Staff have little control over outdoor air
• Actions:
Sign up for Air Quality Index notice
» Pollution Control Agency sends e-mail alerts when they expect poor
air quality (regional)
Avoid being outside at high pollen count times, especially if students are
allergic to particular pollen/s
33. Average Number Of Alerts
6-12 alerts per year in last few years
Most due to PM2.5
Not violation of federal air quality standards thus far
Health issues still valid
34. 2003 – Air Pollution Health Alerts
Expanded AQI to Duluth, St. Cloud, Rochester
Detroit Lakes, Marshall coming soon
Expanded media coverage (Pioneer Press, TV meteorologists,
health reporters, others)
Expanded web & e-mail alert signup
37. School Buses
• State law requires:
Reduce unneeded idling in front of schools
Reroute bus parking zones away from air intakes, if possible
• Actions:
Post “no idling” signs
Maintain bus fleet
Invest in cleaner fuels
Purchase newer, cleaner buses over long-term
R2, R3, R4
38. Other Environmental Issues
• Indoor Air Quality Management Plan
• Cleaning & cleaning products
• Flooring
• Air cleaners
R7
39. Home Environment Resources
• US Environmental Protection Agency
Asthma Home Environment Checklist
» 8 page checklist of common asthma triggers
» Questions to identify triggers & action steps
Clear Your Home of Asthma Triggers fact sheet
• EPA website
www.epa.gov/iaq/asthma/resources.html
42. Care Coordination / Communication
(Health Assistant / Paraprofessional/LPN Role)
Health Assistants / Paraprofessionals / LPNs must alert LSN/PHN/RNs of
students who come in frequently with asthma type symptoms
Monitor students with asthma as directed by LSN/PHN/RN
Perform delegated responsibilities once skills have been validated per
district/school policies
43. Care Coordination /Communication
(LSN/RN/PHN)
• Examples of asthma care coordination activities
Request AAPs on students
Review AAP and/or IHP and develop/modify plan for care coordination
Determine medical insurance status and connect to appropriate provider(s)
Arrange for special transportation (in rare cases) prn
Connect to community resources
44. Care Coordination/ Communication
Communicating with Students
• Educate them to:
Follow an individualized Asthma Action Plan
Avoid or control exposure to their triggers
Use medication appropriately
• Long-term-control medicine
• Quick-relief medicine
Monitor symptoms and response to treatment
• Understand symptoms and peak flow levels
• Seek a health care providers help when needed
45. Communicating w/ Students
Continued..
Get regular follow-up care
Be able to exercise/ play at optimal levels
Be responsible for carrying and using their asthma
medications per school policies
Ask for help when they need it!
46. Care Coordination/ Communication
• Communicating with parents/guardians
Review parent/guardian and student questionnaires
Determine current asthma severity levels
Provide education to family/student as needed
Encourage questions and give feedback
Contact parent/guardian every time a student has asthma symptoms and
or if having poor asthma control
Obtain a signed consent to release/ share information
F11, F14, F3, E1, F7
47. Care Coordination / Communication
• Communicating with health care providers
Report status changes and re-evaluation needs
Advocate for pre-exercise and /or controller medications as appropriate
Arrange for asthma education
Complete IHP and/or ECP if needed
Document as appropriate in Pupil Health Record
Evaluate symptoms, lung sounds and peak flow regularly on poorly
controlled students
F17, F18
48. Communicating With School Staff
Share information with staff on a need to know basis only
Maintain student confidentiality
Provide general asthma education to staff proactively
Provide asthma first aid training to staff
Act as a resource to school staff for questions and concerns
49. Health Office Scenario
• A 4th grade student who you have not seen in the health office this
year for asthma symptoms, has a diagnosis of asthma in her record,
and has albuterol MDI / orders in the health office at school, but no
Asthma Action Plan. She comes into the health office with a persistent
cough.
• What would you do for her?
50. Health Office Scenario Continued...
• Actions
Physical Assessment (respiratory rate, breath sounds, severity of
symptoms)
Ask what she was doing before coming into the health office / what
may have precipitated symptoms
Ask frequency of day / nighttime symptoms
Check height/PF chart for predicted PF and initiate Asthma Record
F5
51. Health Office Scenario Continued...
Check her Peak Flow reading and document in SHOAR F4
» Instruct the child how to do a PF reading
Give albuterol (observe inhaler technique)
Teach/reinforce proper inhaler technique, use of spacer or holding
chamber with inhaler
Monitor her for response to medication
Send note home with the child using the AVN F8 and a PAQ F11
52. Health Office Scenario Continued...
• Two days later, she returns to the health office, with cough and
shortness of breath
• What would you do for this 4th grader first?
• What would be the next steps or what else should you do at this
point?
53. Health Office Scenario Continued…
• What else should you do now?
Re-evaluate her respiratory status and treat as appropriate
Call her parent / guardian to notify, ask for parent questionnaire/more
info.
Suggest she see her health care provider
Ask the child to come see you the next day for a follow up check
If you have consent, fax Asthma Medical Referral/Request to health
care provider
F9
56. Key Asthma Tools
• Components of Asthma Management in the Health Office E2, E3
• Asthma Action Plan w/ imbedded consents, parent letter F1, F2
• Asthma Visit Notification form F7, F8
• Asthma Medical Request/Referral F9, F10
• Pathway for Acute School Asthma Care E6, E7
• Emergency Care Plan - Asthma F18
• Individualized Health Plan - Asthma F17
57. Key Asthma Tools
• Parent/Guardian Breathing/Asthma Questionnaire F11, F12, F13
• Student Breathing/Asthma Questionnaire F14, F15, F16
• School Health Office Asthma Record F4, F5, F6
• Self-administration Asthma Medication Authorization F19, F20
• First Aid for Asthma poster / pocket cards E4, E5
• Asthma Green/Yellow Zone Update F23, F24
• Permanent Health Office Pass F25
58. Components Of Asthma Management In
School Health Office
Two Models Provided in School Asthma Manual
• LSN + Health Assistant (Mpls. Public Schools model) E2
• LSN + Secretary (St. Paul Public Schools model) E3
Purpose: Provides job specific instructions for providing quality asthma care
in the school health office
• Licensed School Nurse, Public Health Nurse, Registered Nurse
• Licensed Practical Nurse
• Health Aid/Service Assistant / Paraprofessional
• Secretary / Administrative Assistant
59. Asthma Screening Questions
Include these 3 questions into your existing student health
questionnaire
1. Does your child have asthma or other breathing problems?
2. Has your child ever been diagnosed by a doctor as having
asthma?
3. Has your child had episode(s) of wheezing (whistling in the
chest) in the last 12 months?
60. Asthma Action Plan (AAP)
• Purpose
Provides a plan to guide the asthma management of individual students
Includes imbedded consents:
» Allow parents/guardians and providers to give permission for medications
to be given at school
» Allow for sharing/release of information between school, clinic, hospital,
child care provider and home care
• Available in English and Spanish
61. Asthma Visit Notification Form (AVN)
• Purpose
Increases communication between the school health office, parents/guardians,
and primary care/asthma care providers
Fill out and send home whenever the student is in the health office with
asthma symptoms
Or when delegated by the LSN/PHN/RN
F7,F8
62. Asthma Medical Request (AMR)
• Purpose
To facilitate communication and care coordination between the health care
provider and the school nurse about the student’s asthma status/management
Fill out and fax, mail to health care providers
You must have the parents written consent to collect medical information
first
F9, F10
63. Pathway for Acute School Asthma Care
• Purpose
Assists school nurses in making decisions regarding the provision of acute
asthma care in the school health office or other school setting
Designed to be used for students experiencing mild, moderate or severe
asthma symptoms
E6, E7
64. Asthma Emergency Care Plan
(ECP)
• Purpose
Provides special instructions to selected school staff on how to respond to
an asthma emergency
Used with students with severe or labile asthma
Individualized for each student with asthma
F18
65. Asthma Individualized Health Plan (IHP)
• Purpose
Provides a Nursing Plan of Care and promotes care coordination and
communication between the school nurse and health office staff regarding
students whose asthma is not in good control
• Also used to document special education nursing services
F17
66. Parent / Guardian Asthma Questionnaire
(PQ)
• Purpose
Used To:
Gather baseline information about the child’s asthma symptoms
Determine the child’s asthma severity level
Determine if the child’s asthma is under control
Develop an appropriate plan of care
• Typically used for students in 5th grade or lower
F11, F12, F13
67. Student Breathing Questionnaire (SBQ)
• Purpose
Used to:
Determine the student’s asthma severity level
Determine if the student’s asthma is under control
Develop an appropriate plan of care
Determine student’s familiarity of their meds, triggers, symptoms etc.
• Used with students in grades 6th grade or higher
F14, F15
68. School Health Office Asthma Record
(SHOAR)
• Purpose
Provides a user-friendly document on which to record many aspects of a
student’s asthma care
• Allows health office staff to:
Record Asthma Medication
Record Peak Flow Readings
Document Asthma Symptoms
Document Education
F4, F5
69. Self-Administration Of Asthma Medication
Authorization / Agreement
• Purpose
To systematize practice regarding self-carrying of asthma medications
between schools
Promotes strong asthma self care skills in students
Agreement between student and school nurse
Used in conjunction with an Asthma Action Plan or may stand alone
F19, F20
70. First Aid For Asthma Poster / Pocket Cards
• Purpose
Provides basic first aid care for asthma and asthma symptoms with directions
when to call 911
Place posters in locations in the school where students and staff are usually
present
Pocket cards may be given to physical education teachers or coaches or other
staff as needed
E4, E5
72. There’s Never Enough Time,
What Can I Do?
• It isn’t possible for school health office staff to get deeply
involved with every student who has asthma so -
• Prioritization is essential!
Determine which students seem to be having the most
difficulty, and focus on them first
73. How Do I Prioritize?
1. Prioritize by “current asthma control / severity level”
2. Focus first on students with the poorest asthma control
regardless of severity level
3. Start working with students whose asthma is poorly
controlled in the moderate to severe persistent asthma levels
74. Which Of These Students With Asthma
Would You Focus On First?
1. A boy with diagnosed moderate persistent asthma who can run, play, attend
school without symptoms and rarely uses his albuterol
2. A girl with current mild persistent asthma who is unable to fully participate
in PE class
3. A girl who’s original severity level was severe persistent but whose
“current asthma severity level” (control) is moderate persistent. She can
play outside better than originally, but still needs albuterol for symptoms 3-
4 times a week at school
75. Which Of These Students With Asthma
Would You Focus On First?
3. A boy with diagnosed moderate persistent asthma who can run, play, attend
school without symptoms and rarely uses his albuterol.
2. A girl with current mild persistent asthma who is unable to fully participate in
PE class.
1. A girl who’s original severity level was severe persistent but whose “current
asthma severity level” (control) is moderate persistent. She can play outside
better than originally, but still needs albuterol for symptoms 3-4 times a
week at school.
77. Components Of Student
& Family Education
Concept of asthma control
Pathophysiology of asthma
Environmental control and triggers
Controller vs. reliever medications and refilling medications
Use of Asthma Action Plan and treatment of episodes
Peak flow meter use
78. Components Of Student
& Family Education Cont…
Signs and symptoms of respiratory distress and when to seek help
MDI with spacer / DPI technique
Nebulizer use and technique (prn)
Importance of relationship with provider and well-asthma check-ups
Flu shot every fall
Self-care, especially for students as they get older
79. Strategies To Educate When Time Is
Limited
Give short asthma education messages when meeting with with students
Use innovative / interactive asthma education tools (computerized asthma
games, internet-based asthma control tools, videos) with students /
families
80. The Best Laid Plans..
You can increase the likelihood of asthma management success
(compliance) by:
1. Reviewing Asthma Action Plan and making sure student understands
how to use it
2. Ask how controller medications fit into the student’s daily routine (can
they handle it?)
3. Identify obstacles or barriers to the student/family carrying out the plan
as prescribed
81. “I Can’t Manage This By Myself.
Who Else Should Be Involved”?
82. Referring To Community Resources For
Education And Case Management
LSN/PHN/RNs can utilize case managers, home visiting professionals, and
asthma educators from health plans, hospitals, clinics, public health, to help
educate and/or case manage students whose asthma is poorly controlled
Connect students/family to community education, asthma camp, other
community resources
84. CDC’s Strategies For Addressing Asthma
Within A Coordinated School Health
Program
Six Strategies
1. Establish management and support systems for asthma-friendly
schools
2. Provide appropriate school health and mental health services for
students with asthma
3. Provide asthma education and awareness programs for students and
school staff
85. Strategies Continued…
4. Provide a safe and healthy school environment to reduce asthma
triggers
5. Provide safe, enjoyable physical education and activity opportunities for
students with asthma
6. Coordinate school, family, and community efforts to better manage
asthma symptoms and reduce school absences among students with
asthma
86. Asthma Goals For School
Health
Healthy school environment
Health services in school
Asthma education
Supportive policies
Sound communication
1997 National Asthma Education and Prevention Program
(NAEPP)
87. Spearheading School-wide Asthma Best
Practices At Your School
See Checklist in manual for suggestions
Create a multi-disciplinary plan for improving asthma management in your
health office, school and/or district
Improve own practice
Educate other school staff
Involve all disciplines within the school setting
88. Community Involvement
Get involved with the Minnesota Asthma Coalition, and/or the regional
Asthma Coalition in your area
Contact your legislators and insist on legislation to support asthma-friendly
policies
Anti-smoking laws
Healthy housing initiatives
Supporting Clean Indoor act
Support stricter pollution control measures
89. Conclusion
Asthma is a big challenge for Minnesota
Working together with parents and health care providers, we
have the ability to positively and dramatically impact the health
of children who have asthma!