2. Catch Your Breath Asthma Survival Skills Catch Your Breath Asthma Survival Skills Provided by: Generously supported by the Robert Wood Johnson Foundation

3. Asthma Facts Most common chronic disease in childhood Almost 9 million American children have asthma. (Over 100,000 in Wisconsin) Children under 6 have the highest rate for hospital admissions. #1 reason children are admitted to Children’s Hospital of Wisconsin Asthma is the number one cause of school absences.

4. Causes of Asthma HeredityHeredity Exposure to environmental tobacco smokeExposure to environmental tobacco smoke RSV (Respiratory Syncytial Virus) during infancyRSV (Respiratory Syncytial Virus) during infancy Too much or not enough exposure to triggersToo much or not enough exposure to triggers Air pollutionAir pollution There is no single reason for the onset of asthma

5. Goals of Asthma Management  No asthma symptoms during day or night, including cough. Sleep through the night.  Best possible lung function  No missed school or work  No hospital or ER visits  Few side effects from medicines  Satisfied with asthma care

8. What is Asthma? -Inflammation (swelling) -Mucous Production (snot) - Bronchospasm (muscle tightness)

9. Early Warning Signs  Cough  Mood Changes  Change in facial appearance  Breathing changes  Verbal complaints  Itchy chin or neck  Itchy, watery, or glassy eyes  Runny nose  Head stopped up  Sneezing  Dark Circles under eyes  Getting out of breath  Chest hurts

10. Symptoms of Asthma Flare-up  Cough  Wheeze  Shortness of breath  Chest tightness  Retractions

11. Signs that Medical Help is Needed  Changes in color (fingernails/lips turn blue/gray)  Skin between the ribs is pulling in (retractions)  Nostrils open wider - nasal flaring.  Grunting

12. Additional Signs that Infants Need Medical Help Infants Need Medical Help Additional Signs that Infants Need Medical Help Infants Need Medical Help Breathing rate increases to over 40 breathes/minute while infant is sleeping. (Count breathes for 15 seconds X 4)Breathing rate increases to over 40 breathes/minute while infant is sleeping. (Count breathes for 15 seconds X 4) Trouble feeding or feeding stopsTrouble feeding or feeding stops Cry changes in quality (softer and shorter)Cry changes in quality (softer and shorter)

13.  THINGS THAT MAKE ASTHMA WORSE  EVERYONE IS DIFFERENT

14. Activators/Triggers Cockroaches Control spills, food mess, and leaks Use baits Dust Mites Use pillow and mattress covers Damp dust Wash bedding in hot water Animal Dander No pets is best Keep pets out of sleeping area

15. Activators/Triggers Tobacco Smoke Be careful of secondhand smoke Wash hands, use mouthwash Pollens and Air Pollution Midday = high levels Use air conditioning, not fans Molds Clean mold with bleach solution Plant soil is a source Check outdoor, plastic toys and equipment Wood Smoke

16. Activators/Triggers Strong Odors Perfumes, scented candles, cleaning products Colds and Infections Wash hands frequently Encourage yearly flu shots Exercise Plan warm up activities Allow for pre-medication Weather Sudden changes in temperature Cover nose and mouth in cold weather

17. Contents of Cigarette Smoke AcetoneMethanol Nail Polish RemoverRocket Fuel Ammonia Carbon Monoxide Floor and Toilet CleanerCar exhaust fumes FormaldehydeButane Body Tissue PreserverCigarette lighter fluid Stearic AcidDDT Candle WaxInsecticides

19. Long- Term, Control Medications Decrease the inflammation/swelling Advair

20. Quick Relief Medications Loosens your muscles & stops the wheezing Albuterol for Nebulizer

21. Spacers

22. ©1998, Respironics Inc. Without Spacer With Spacer

23. Why Control Asthma? M. Zacharisen

24. Is the Asthma in Control?  Does the child need a "quick-relief inhaler" more than TWO TIMES A WEEK?  Does the child wake up at night with asthma more than TWO TIMES A MONTH?  Does the family refill the "quick-relief inhaler" more than TWO TIMES A YEAR? Rules of Two TM is a registered trademark of the Baylor Health Care System.

25. Risk of Death  Sudden, severe exacerbations  Intubation  Admission to ICU  > 2 hospitalizations in the past year  3 or more ED visits in the last year  Hosp/ED visit in the last month  Oral corticosteroids  > 2 canisters per month of quick relief  Poor perception of asthma symptoms  Psychiatric/psychosocial problems  Low socioeconomic status/urban living  Alternaria (mold) sensitivity  Illicit drug use

26. Mucus Plug

27. Asthma Care Plans  Care plans can be used to determine how to help a child with asthma based on symptoms and/or peak flow meter readings.  List asthma medications, when to take them, and how much to take.  Share copies with childcare providers, school teachers and administration, coaches, babysitters, and anyone else caring for the child.

28. Asthma Diaries  Diaries help track Asthma symptoms Use of medicines Peak flow numbers Triggers you’ve been in contact with  Diaries improve communication with your doctor

29. Gives information on how lungs are working

30. REMEMBER To prevent & control an asthma episode:REMEMBER episode: Develop & follow an asthma care plan. Plan ways to reduce the child’s contact with triggers. Treat symptoms early. Be prepared for any changes in symptoms. Know when a doctor’s help is needed & get help right away. Flare-ups DO NOT have to be a crisis!

31. Thanks!