Product # 145B
Table of Contents What is asthma?.........................................................2 normal breathing..................................................2 asthma flare-ups and triggers..........................3 dust mites................................................................6 triggers checklist...................................................8 avoiding triggers...................................................9 Treating asthma...................................................... 10 peak flow meter................................................. 11 early warning signs checklist........................ 14 long-term medicines......................................... 15 quick-relief medicines...................................... 17 ways to take medicines.................................. 20 Using an asthma diary.......................................... 25 asthma diary....................................................... 26 Working with the doctor...................................... 27 asthma action plan........................................... 28 When to call the doctor........................................ 29 Working with the teacher.................................... 30 Sample school letter............................................... 31
This book is to help you learn and should not replace any advice or treatment from your health care team.
Asthma on the go.................................................... 32 Resources................................................................... 33
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or call toll free: 800-241-4925 Published and distributed by: Pritchett & Hull Associates, Inc. Printed in the U.S.A.
To keep the text simple we often refer to your child as “he/him.”
Help your child help himself Your child is one of many children who have asthma. Someday, he’ll be able to manage his asthma without your help. But for now, it’s up to you to take charge of his treatment and help him learn how to manage his asthma. The best way to do this is with a treatment plan made just for him. This book will help you, your child and his doctor: know what triggers (causes) your child’s asthma flare-ups learn how to prevent and treat his flare-ups set up an asthma action plan just for him
Asking for help When you are not with your child, he may be shy about asking for help. Teach him that it’s OK to tell other adults about triggers he needs to avoid or when he’s having a flare-up.
What is asthma? Asthma is a chronic (long-term) disease of the airways in the lungs. It’s not catching, but it tends to run in families (inherited). Your child may go for several weeks, months or even years with no symptoms or signs of asthma and then have a flare-up of coughing, wheezing, shortness of breath. Even when he’s not having symptoms, he is not cured. He still has asthma. So continue to follow his treatment plan.
Normal breathing When we breathe, air flows through the windpipe (trachea) into 2 large air tubes (bronchi), then into smaller tubes (bronchioles), then to tiny air sacs (alveoli) in the lungs.
trachea
bronchi bronchioles alveoli
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Asthma flare-ups With asthma, your child’s: airway muscles tighten and squeeze the airways closed airways swell and become inflamed, blocking the air flow airways make so much mucus that air cannot pass through them
bronchial tube
alveoli mucus trapped air
During a flare-up (attack or episode), your child may:
inflamed, swollen airways
cough be short of breath have chest tightness wheeze (a high-pitched whistling sound of air trying to move in and out of his airways)
What causes a flare-up? Things that cause asthma flare-ups are called triggers. There are many types, and they vary from child to child. Colds, flu, smoke, exercise and things he is allergic to are some of the more common triggers. Use the check list on page 8 to help you find out what your child’s triggers are so you can help him avoid them. They are not always easy to spot, so it may take some time.
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exercise Most kids run and play very hard. For some children, this may trigger a flare-up. If your child feels a flare-up coming on, he should stop and rest. He may also need to take his rescue medicine. To help prevent a flare-up, have him do these before exercise: warm up and stretch in cold weather, cover his mouth and nose with a scarf, muffler or ski mask (This helps warm the air before it reaches his lungs.) use his quick-relief medicine 15 minutes before exercise if his doctor has said to (see page 18)
Exercise is good for your child. With good asthma control, your child should be able to play the sports she enjoys.
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allergens Over 80% of children with asthma also have allergies to things like dust mites, molds, pollen or animals (saliva and flaking skin). These things are called allergens. When a child is exposed to some allergens (especially dust mites), he may have an asthma flare-up. If you think your child may be allergic to something, talk with his doctor.
germs and infections One of the most common triggers for children is an infection of the airways—like a cold or the flu (influenza). Flu shots are recommended for children with asthma*. Ask your doctor if your child should get a flu shot each year. Kids pass many germs to each other by coughing, sneezing and sharing things like spoons, cups and toys. Teach your child to wash his hands often to avoid germs.
* Source: CDC, National Center for Infectious Diseases, ACIP.
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dust mites Dust mites are tiny insects that live in house dust. They are so small, you can’t see them. They’re very common and can trigger flare-ups when breathed into the lungs. It’s very important to control dust mites in your child’s bedroom. Make it as dust-free as you can.
4 Wash bed linen in hot water (130°F*) each week.
4 Put airtight, allergy-proof, zippered covers on his pillow, box spring and mattress.
4 Keep stuffed animals away from the bed. Avoid stuffed animals that can’t be washed often in hot water (130°F*).
4 If your child has a bunk bed, clean it well each week. If he has a bed with a canopy, wash the canopy in hot water (130°F*) each week.
4 Clean your child’s bedroom each week. Dust with a damp cloth. Arrange for him to be out of the room.
4 Hardwood floors with rugs that can be washed are best for your child’s bedroom. But if his room has carpet, vacuum each week, and shampoo every 3 to 4 months.
4 Use shades instead of curtains, or wash curtains in hot water (130°F*) every month. * At 130°F, water is very hot. So teach your family to be careful using hot water.
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other ways to avoid dust mites:
4 Give your house a good cleaning every three months. (Dust with a damp mop or sponge.) Arrange for your child to be out of the house when you do this. If he must be there, have him wear a dust mask.
4 Use a vacuum with a HEPA (high-efficiency particulate arrester) filter or a double bag.
4 Get rid of clutter that collects dust. 4 Try a dehumidifier to keep indoor humidity below 50%. (Do not use a vaporizer daily. This will increase humidity.)
4 Change furnace filters often (at least every three months). Change every month during winter.
4 Cover heat vents with an air filter or cheese cloth. shades instead of curtains plain lampshade (not pleated)
hot waterwashable stuffed animals
non-fabric headboard non-fabric furniture
hot water-washable bed linens hot waterwashable throw rugs airtight, allergy-proof pillow and mattress covers
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child’s name
‘s Triggers
Check the things that trigger your child’s asthma. Let your child check them if he can.
general irritants (should be avoided by everyone with asthma) tobacco smoke spray deodorants, hair sprays, insect sprays, cleaning sprays carpet freshner, baby powder f ragrances, perfume, cologne, scented candles, incense, Plugins®, room freshner
Every year, secondhand smoke triggers up to 1 million asthma flare-ups in children.
chalk dust, odors from markers smog, pollen and other air pollution car and truck exhaust
others colds, flu, sinus problems
changes in temperature, humidity or air pressure
exercise ursts of emotion b that affect breathing (such as crying, laughing, etc.)
o dors from cleaning fluids, paints, furniture polish smoke from burning wood or leaves
some medicines
allergic triggers (avoid if you are allergic to them)
d ust mites (see pages 6–7) cats, dogs and other furry pets cockroaches mold, mildew s ome foods (rarely) pollens, grass, trees, ragweed This page may be copied for your child’s use.
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Fish are great pets for kids with asthma— no flaking skin.
© Pritchett & Hull Associates, Inc.
Avoiding triggers Avoid smoke and smoky places. Do not smoke or let anyone else ever smoke in your home or car. Have your child stay away from chalk dust and use odor-free markers in school. Avoid air pollution! Use airconditioning, not fans, at home. Keep windows closed. If you have air-conditioning in your car, recirculate the air or keep him inside during traffic rush hours. Use unscented liquid or solid products, not sprays. Use a stove vent to get rid of cooking fumes. Try to keep furry pets outdoors. Never let them in your child’s bedroom. Wash them often (every week). Use an air cleaning device with a HEPA filter in his bedroom. Put it up on a table—not on the floor. Avoid mold (wet leaves, damp basements, bathrooms). Fix leaking pipes or faucets. Clean moldy surfaces. Use poison bait or traps to control roaches. Do not leave food or garbage out uncovered. Keep him away from very cold, hot or humid air. Don’t buy foods that may cause a flare-up (foods that are triggers for your child). Read all food labels. Record his asthma triggers on his asthma diary (page 26). This will help you know what to avoid in the future. If he can, let him write in his diary, too. 9
Treating asthma Asthma causes more hospital stays for children than any other chronic disease. It causes more visits to the emergency room than any other childhood disease. You can prevent most of these scary events for your child. His asthma does not have to cause you to miss work or cause him to miss school. Work with his doctor to set up a written asthma action plan. This may include: learning your child’s early warning signs avoiding triggers (see pages 4–9) learning what medicines to take and how to take them With a good asthma action plan, your child should: be able to keep up with his usual activities (including exercise, sports and school) be free of flare-ups sleep through the night without waking (due to asthma) use a quick-relief inhaler less than 2 times a week have no visits to the hospital or emergency room (due to asthma) have few side effects from asthma medicines
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We believe that you have the right to know as much as you can about your health. Our goal is to give you enough facts to get the main points clearly in mind. We do this with medical accuracy, warmth and humor. The result for you: less tension, more healing and a good idea of what to ask your doctor, nurse or others.
Consultants/reviewers for this book: Jo Ann G. Bedore, RN, BS, AE-C, TTS Akron Children’s Hospital Akron, OH DJ Feather, RRT Pediatric Asthma Educator Atlanta, GA J. Michael Halwig, MD Atlanta Allergy & Asthma Clinic Austell, GA Carolyn M. Kercsmar, MD Director, Children’s Asthma Center Case Western Reserve University Cleveland, OH
Pritchett & Hull Associates, Inc. ®
1-800-241-4925
A. A. Marie Singletary-Schuster, RN Former Coordinator, Asthma Center for Education Scottish Rite Children’s Medical Center Atlanta, GA