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

2. “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, BC
Physician to Alexander the Great~

3. 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

4. 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

5. 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

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

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

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

9. 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)

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

11. 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

12. 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

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

14. 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

15. 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

16. 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

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

18. 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

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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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)

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

29. 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

30. 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

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

32. 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

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

34. 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

35. 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

36. 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

37. 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

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