Healthy Children-Healthy Lungs Asthma in Children in Child Care developed by June Cuddihy, RN,CS,MSN Catholic Charities, Unified Child Care Program

“When health is absent,wisdom cannot reveal itself, art cannot become manifest, strength cannot fight, wealth becomes useless, and intelligence cannot be applied”. ~Herophilius of Chalcedon,335-280 BC Physician to Alexander the Great~

What Is Asthma An estimated Five Million children suffer from asthma Asthma is a chronic inflammatory disorder associated with airway hyperresponseness, airflow limitation,and respiratory symptoms Asthma is characterized by coughing, chest tightness and difficult breathing

Early Warning Signals Every child has a built-in warning system These signals can be : Seen Heard Felt Every child has their own patterns of signals

Continued You can make observations a habit and be able to recognize patterns These patterns are messages to get going and head off increased symptoms

What to Look For Anxious or scared look Cough Unusual paleness or sweating Flared nostrils Pursed lip breathing Fast breathing

Continued Vomiting Hunched over posture Restless during sleep Fatigue Space between the ribs may sink in when the child breaths

What to Listen For: Coughing when the child has no cold Clearing the throat a lot Irregular breathing Wheezing Noisy, difficult breathing

How to Listen: Place your ear to the child’s back and hand on the child’s chest You will feel the chest go up and down with breathing Listen for squeaking or unusual noises. a signal that intervention may be necessary (wheezing)

Signs of an Attack Itchy, watery, or glassy eyes Itch, sore throat Sneezing Congestion Restlessness Runny nose Dark circles under the eyes

What to Do Immediately: Reassure the child Institute the Asthma Action Plan Each child has different asthma symptoms Learn these symptoms and respond to the symptoms to prevent an severe episode Parents and physician need to be informed

Additional Steps to Take: Help the child by a calming manner Keep child and other children informed of what you are doing If you identify what triggered the symptoms, remove it or remove the child The Action Plan can help you decide what further measures to take

Types of Asthma Medications Anti-allergy medications Anti-inflammatory medications Bronchodilators-rescue medications

Responsibilities of Providers: Learn the basics of asthma Consultant with the child’s parents, physician and your health consultant Learn about the child’s symptoms Learn about the treatment

It Is Important to Find Out the Following: How severe is the asthma How to judge the severity of an attack Is treatment needed Do you call 911 What triggers attacks for each child

Continued What medicines are to be given to the child What are the effects, side effects and actions of the medications How to use a nebulizer correctly

Continued How to use an inhaler How to use a peak flow meter if age appropriate What to do in an emergency

Collect and Record Information: Have forms completed by physician, that give exact information called an Asthma Action Plan Record medication and use your observation skills to identify the child’s symptoms

Continued Share all information with the parents Develop a management plan and an action plan

Continued Keep all information in the child’s file for easy access Provide staff training on asthma Modify the environment as needed Become familiar with the early signs and symptoms to reduce the incidence of a severe episode of asthma

When the Asthma Episode Occurs the Staff Is Prepared To: Remove the child from known triggers Help the child rest in a sitting position Help the child to relax Help child to calm self Calm other children Administer medications as needed

Continue Have child blow into the peak flow meter if age appropriate Call emergency contacts Stay with the child and observe closely until help arrives Document the episode , actions and use of medication

Responsibilities of the Physician Assess the child care setting Train the parents and child care provider Review and approve medications Act as a resource Develop an asthma plan and explain as needed

Responsibilities of Parent and Child Understand the child’s asthma management Ensure that the child care provider is thoroughly trained Notify child care provider of any changes Help the child describe their symptoms

How to Decide if a Child Should Go to Child Care: May Go if Signs and Symptoms are limited to: Stuffy nose, but no wheezing Wheezing goes away after medication Ability to do usual activities No extra effort to breathe

The child Should stay Home if These Symptoms are Present: Infection, sore throat, or swollen, painful neck glands Fever; face is hot and flushed Wheezing or coughing after asthma medications Difficulty with activities Breathing with difficulty or breathing fast

Five Emergency Signs Chest and neck muscles are working hard Struggling to breathe Trouble walking or talking Peak flow rate gets lower, or does not improve after treatment and Lips or fingernails are gray or blue (late sign in very young children)

If you see any of these emergency signs, call 911 immediately and activate emergency procedures.

What Is Good Control: No coughing No waking at night No shortness of breath Normal respiratory rate No wheezing or chest tightness Normal lung functioning

Managing the Child With Asthma; Regular assessment and monitoring Control of factors that contribute to symptoms and severity of episodes Pharmacological therapy Educating the child, family and caregivers to adhere to written asthma management plan

Two Asthma Management Plans: A daily Management Plan--explaining regular medications and measures for control of asthma An Action Plan--describing actions to take

Three Actions to Help Control Asthma: Learn what triggers or starts or prompts asthma symptoms and avoid them Respond quickly to warning signs Make sure you have two working management plans

Develop Strong partnerships with parents and physician Phone numbers and resources readily available

Summary for Managing Childhood Asthma Are: To Control asthma by reducing environmental triggers Promote a healthy lifestyle including proper rest, exercise, and nutrition Ensuring the proper use of medication

Summary To foster emotional health so the child views self as a healthy and confident To prevent symptoms when possible To inform all relevant personnel and provide training as needed

There is No Cure At Present Asthma can be controlled We should expect nothing less Remember Asthma is as much a disease of communication as inflammation Education programs are available to support child care providers

Vision for the 21st Century So what is the good news in all of this? “ Almost all children with asthma can be free of symptoms with proper treatment and management.” Vision for the 21st Century Every child in America will live, learn, work and play in environments and setting that do not cause or worsen asthma

“There are no such things as incurables only things for which man has not found a cure.” ~Bernard M. Baruch, 1870-1965~