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Asthma! an interactive smartphone guide to basic asthma self-management for people 12 years and older For interactive features, open with Adobe Acrobat
Disclaimer: Information in this booklet is based on national guidelines for people 12 years and older. ALWAYS check with your doctor first to determine the treatment and doses of medication that are right for you. Developed BY people with asthma FOR people with asthma Written by Jennifer Mammen, PhD Kimberly Arcoleo, PhD, & Hyekyun Rhee, PhD University of Rochester School of Nursing @ University of Rochester School of Nursing Copyright 2017 Jennifer Mammen
Contents My asthma medications
What is Asthma? Uncontrolled asthma can scar your lungs
Is your asthma controlled? What asthma medication does Do you know all the symptoms of asthma?
National guidelines for treating an asthma attack Life threatening symptoms!
How to take puffer inhalers Why you should use a spacer How to take dry powder inhalers Measure your lungs (peak flow meter) Asthma triggers - what to do
Exercise asthma - what to do Asthma diary My Asthma Action Plan
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What is ASTHMA? ASTHMA causes: Swelling Obstruction Spasms
SOS!
INSIDE LUNGS =
swollen + clogged
NORMAL ⟿ INFLAMED ⟿ invisible
AWFUL!!
gh cou mucus
e
eez
Wh
Swelling CAUSES Obstruction + Spasms s Tightnes
if you STOP swelling first, you won’t get symptoms. Uncontrolled asthma can scar your lungs Let’s Talk About Asthma©
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Why does it matter if I have symptoms if it doesn t bother me?
• • • •
Asthma INFLAMMATION (swelling) causes INJURY to your lungs. When injury heals, it leaves a small stiff SCAR. Over time, the scars add up (REMODELING). Your lungs get stiff, making it harder to breathe.
REMODELING it permanently scars your lungs. control medication stops SCARRING and prevents SYMPTOMS Let’s Talk About Asthma©
Let’s Talk About Asthma©
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Check your ASTHMA CONTROL: OVER THE LAST MONTH
ALL green =
ANY yellow but NO red =
ANY red =
VERY POORLY WELL NOT WELL CONTROLLED CONTROLLED CONTROLLED
symptoms
2 or LESS times a week
3 or MORE times a week
MANY times a day
night time wake up for symptoms
2 or LESS times a month
3 or MORE times a month
4 or MORE times a week
using rescue inhaler
2 or LESS times a week
3 or MORE times a week
3 or MORE times a day
activity limitations
NONE
SOME limitation
VERY limited
Peak Flow
MORE THAN 80 % of best
50 to 80% of best
LESS THAN 50 % of best
Your asthma is: adapted from the National Guidelines (2007) Figure 3-4c
There are really only 2 KINDS of
HOME
Take if needed
Take every day
ASTHMA MEDICATION
SLOWER CONTROL MEDICATION
(e Prevents swelling and obstruction.
Control medication STOPS scarring in your lungs Ex. (Flovent, Advair, Asmanex)
Ex. 1 puff twice every day (Takes days to weeks to start working )
FASTER. RESCUE MEDICATION
Treats spasms (active symptoms)
Does NOT treat swelling - Does NOT stop scarring
Albuterol Inhaler Ex. 2 puffs every 4 hours as needed for symptoms Works in 5-20 minutes
CONTROL! CONTROL/RESCUE!
RESCUE!
Remember:!
Swelling! Obstruction! Spasms!
SOS! !
STOP the SCARRING—CONTROL it! Let’s Talk About Asthma©
What are your symptoms of asthma?
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YES
cough
YES
mucus
YES
wheezing
YES
short of breath trouble breathing
YES
cough at night
NO!
FEVER
YES
chest pain/tightness
YES
symptoms with exercise
YES
clearing throat a lot
YES
tiredness
SYMPTOMS = SOS* *Swelling Obstruction Spasms
Let’s Talk About Asthma©
o
o
o
: HOME
t
tt
t
t
FIRST STOP AND CHECK: Do you have any SYMPTOMS of LIFE THREATENING ASTHMA?
*
YES
TAKE Albuterol Inhaler 6 puffs
TAKE Albuterol Inhaler _____________ 2-6 puffs _____________ (wait 20 minutes) S"ll got symptoms?
REPEAT Albuterol Inhaler _____________ 2-6 puffs _____________ (wait 20 minutes) S"ll got symptoms?
CALL 911 go to ER immediately!
ADD NOTES HERE:
NO
AFTER symptoms are gone, recheck NO your Peak Flow
>80% OK for today (keep track) NO
REPEAT Albuterol Inhaler _____________ 2-6 puffs _____________ START _______ Steroids CALL your Doctor S"ll got symptoms? NO
50-80% CALL your doctor
<50% go to ER
Adapted from U.S. DHHS, NIH. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (EPR-3). https://www.nhlbi.nih.gov/files/docs/guidelines/11_sec5_exacerb.pdf. 2007), p 381-2
Life Threatening
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ASTHMA SYMPTOMS tap on buttons to learn why
Struggling to breathe Blue lips or nails Trouble talking Trouble walking
Use neck/chest muscles Exhausted Peak Flow below 50%
get immediate medical attention !! Let’s Talk About Asthma©
ASTHMA ATTACK!
How to take inhalers (correctly)
Let’s Talk About Asthma©
1. 2. 3. 4. 5. 6. 7. 8.
because ANYONE can do it wrong.
Stand up. Shake the inhaler. Breathe OUT. Hold the inhaler up right. Start breathing in AND puff the inhaler. Breathe in as deep as you can. Hold for 10 seconds, breathe out. Wait 1 minute and repeat if needed.
MAKE SURE YOU RINSE YOUR MOUTH AFTER TAKING STEROID INHALERS.
(or you can get a yeast infection in your mouth.)
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Don’t forget to use a Spacer!
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Spacers help more medicine get in your lungs. When you use your inhaler with out a spacer a lot of the medicine gets lost. 1. 2. 3.
4. 5. 6.
Shake the inhaler and attach it to the spacer Breathe OUT Put the spacer mouth piece in your mouth, squirt in one puff into the chamber, and then inhale slowly through your mouth Hold for 10 seconds Wait 1 minute and repeat as directed Clean your spacer as directed
!
get more medicine in your lungs!!
"
How to take
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dry
powder inhalers 1. Stand up. 2. Open and prime the inhaler (twist or click back) 3. Hold the inhaler out straight and flat. 4. Breath OUT completely 5. Seal your lips tightly around the hole 6. Suck IN the medicine HARD and FAST, â&#x20AC;¨ as deeply as you can. 7. Hold for 10 seconds, breath out through your nose MAKE SURE YOU RINSE YOUR MOUTH AFTER TAKING STEROID INHALERS.
(or you can get a yeast infection in your mouth.)
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How to use a Peak Flow Meter (PFM) 1. Set the slider to 0. Stand up straight.
2. BREATH IN.
Put the PFM in your mouth and seal your lips tightly around it. Hold it straight out like a trumpet.
3. BLOW OUT. Take the biggest breath you can. Blow HARD and FAST. ϋϙϚ ϕό м ϚϘϏϋϙͧ
4. WRITE IT DOWN.
0
Write down the score.
_____________
5. RESET + REPEAT
Set the slider to 0 and try twice more.
The BEST (highest of 3 tries) is your PEAK FLOW! Let’s Talk About Asthma©
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PEAK FLOW METERS show how FAST you can blow air out of your lungs. It’s a way to measure
Swelling + Obstruction + Spasms
Find YOUR personal best (Your BEST EVER score)
= Good! ! = Caution! " = Danger!!! #
GREEN 81-100% ➔ YELLOW 0-80% ➔ RED < 0% !! ➔
BEST SCORE TODAY ÷ BEST EVER=% n ert
r
0
nn
er
n
t
t
e tE E
e tt
÷
0
te
r er ent
=
0%
Are you green, yellow, or red?
?
Let’s Talk About Asthma©
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Learn your
ASTHMA TRIGGERS pests + pets chemicals Chemicals Personal Care Products Home Cleaners
exposures Cold weather Fumes
Pests: Roaches, Rats, Mice Pets: fur / feathers
w Talk about ho ur yo le nd ha to triggers with re your healthca . er id ov pr
Cigarettes Mold Pollens Dust
consumables
Food Medicine
events
Exercising/ Sports Laughing Stress Catching a cold
ASTHMA TRIGGERS
are ANYTHING that causes asthma symptoms.
if you smoke…
kick the habit! Learn about managing triggers at: https://www.cdc.gov/asthma/triggers.html
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People with asthma should exercise and be active just like everyone else PROS: • Exercising strengthens your lungs • Exercise decreases inflamma5on • Exercise = fewer symptoms over 5me. Exercise is being healthy • Exercise is part of controlling asthma.
CONS: • Exercise can trigger symptoms.
SOLUTION: • You may need to take your albuterol inhaler 15 minutes BEFORE exercising. Let’s Talk About Asthma©
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Date
Symptom Diary Any Symptoms?
Best EVER
Took Took Rescue Control
0 Peakflow
................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. ................. .................
Zone 0%
0% 0%
0% 0% 0%
0% 0% 0% 0% 0%
0% 0%
0%
Want more information about asthma? Check out these free sites:
Teen guide to asthma
Allergy & Asthma Network
Let’s Talk About Asthma©
American College Asthma
? ? ? ? ? ? ? ? ? ? ? ? ? ?
Let’s Talk About Asthma©
MY ACTION PLAN
GREEN
HOME
peak flow TODAY
Rare symptoms (2 or less x week) Peak flow > 80%
÷
0
Keep it up - no changes!
Continue your control medication:
0 Best EVER
=
0%
Ex. (Flovent, Advair, Asmanex)
?
YELLOW
Ex. 1 puff twice every day
SOME symptoms (off and on > 2 x week) Peak flow between 50% - 80% Albuterol Inhaler Take __________________________ for symptoms Ex. 2 puffs every 4 hours as needed for symptoms
What to do:
A LOT of symptoms (constantly)
RED !
or Peak flow < 50% Albuterol Inhaler Take ________________________ immediately
What to do:
ASTHMA ATTACK!
If you have life threatening symptoms go to the ER Adapted from U.S. DHHS, NIH. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (EPR-3). https://www.nhlbi.nih.gov/files/docs/guidelines/ 11_sec5_exacerb.pdf. 2007), and https://www.nhlbi.nih.gov/files/docs/public/lung/asthma_actplan.pdf