A nonprofit independent licensee of the Blue Cross Blue Shield Association. Managing Your Asthma

Transcription

1 A nonprofit independent licensee of the Blue Cross Blue Shield Association Managing Your Asthma

2 Excellus Health Plan, Inc. 2010

3 Contents Introduction...1 Goals...1 What is Asthma...2 Asthma Signs and Symptoms...3 Asthma Triggers Asthma Treatment...5 Medications Inhaler/Nebulizer Peak Flow Meter...10 Asthma in School...10 Asthma In the Workplace...11 Traveling with Asthma...12 Croup...12 Asthma Diary...13

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5 Introduction Working with your doctor Feeling comfortable talking with your doctor is an important step to managing your asthma. This will help you play an active role as a team member with your doctor. Good management of your asthma will allow you to take charge of your life. Here are some tips to help with asthma management: G Learn what asthma is and what your triggers are. G Take your medications as prescribed. G Learn to use the devices correctly. G Keep an asthma diary that includes symptoms, activities and peak flow readings (if you are measuring peak flow). G Obtain a yearly flu vaccine. If possible, have all family members get a flu vaccine. G Talk with your doctor regarding a pneumonia vaccine to see if you are a candidate. G Work with your doctor to see if an asthma action plan is needed. G Understand any changes in the asthma treatment and/or asthma action plan. G Make a list of questions or concerns prior to your doctor s appointment. G Schedule a doctor s visit just for asthma at least every six months. Tell your doctor G How often you are using your rescue inhaler. G What asthma symptoms you have. G How often nighttime symptoms occur. G If your asthma is limiting your ability to exercise, work, attend school or do other daily activities. Goals Goals of asthma care: G No asthma symptoms day or night. G No missed school/work/home activities. G Maintain normal or near-normal lung function. G Little or no use of rescue inhaler. G No adverse effects from medications. 1

6 What Is Asthma What is normal breathing? Normal breathing is when air (oxygen) comes in through your nose and mouth and goes through your airways to your lungs. The air ends up in small sacs called alveoli in your lungs. When you breathe out, you get rid of carbon dioxide from your body. What is asthma? Asthma is a chronic inflammatory disorder of the airways. Inflammation and tightening in the airways of your lungs make it hard for you to breathe. With asthma, inflammation is always present, but you may not notice it until you come in contact with a trigger. Here is what happens: Inflammation The cells of the inside walls of the airways become swollen and irritated. As these cells swell, they rupture and leak fluid into the airways. This produces a thick mucous, making the airways smaller and more difficult for the air to pass through into the lungs. Tightening (constriction) There are also muscle bands that surround the airways. They help to hold the airways open so air can pass through. When they cannot expand any further because of the swelling, they twitch (bronchospasm) and squeeze with each breath. The tightening causes the airways to become narrow so air cannot get through. This may cause you to feel tightness in your chest. Some of the airways are so tiny that there is not much room for swelling and mucous. The mucous then plugs the airways, which causes you to start coughing and makes it difficult for you to breathe. In some people, this inflammation causes recurrent episodes of coughing, wheezing, breathlessness and chest tightness. These are warning signs that something is wrong. You should learn what your particular symptoms are. Asthma flare-ups can be related to many different causes It is not known why some people have asthma and others do not. Heredity may be the reason for many people. For others, allergens or irritants in the air can trigger an allergic reaction, causing asthma to flare up. However, no matter what the cause is, we do know the basic problem is inflammation and constriction of the airways. *****Plants with pretty flowers are typically insect-pollinated. Very little of the pollen becomes airborne to cause allergy symptoms. Allergic Asthma: Triggered by inhaling or ingesting an allergen that causes an allergic reaction. Pollen from trees, weeds, grass Dust mites Mold spores Cockroaches Animal dander Food allergies Aspirin or other non-steroidal antiinflammatory medication Insect stings Non-A Non-Allergic Asthma: Trigger may be something irritating the airways rather than an allergen. Anxiety, stress, crying Exercise Cold air or dry air Hyperventilation Cigarette smoke or campfire smoke Viruses Chemical fumes Perfumes and scented candles Heartburn and GERD (gastroesophageal reflux disease) 2

7 Asthma Signs And Symptoms An asthma attack can happen suddenly or over a few days. These symptoms can occur anytime. It is important to know what triggers your asthma symptoms. Talk with your doctor if your asthma is not controlled. Asthma cannot be cured, but it can be controlled with medications and scheduled visits to your doctor. It is important to work with your doctor to develop an action plan. An action plan will include instructions of what to do when symptoms occur. Symptoms may include Breathing fast. Having less energy. Waking at night. Wheezing a whistling noise with breathing. Constant cough with or without mucous. Shortness of breath. Tightness in the chest. Allergy symptoms Sneezing. Runny nose. Stuffy nose. Coughing. Itchy, watery eyes; itchy nose and roof of mouth. Dark circles under eyes. Some asthmatics also have allergies to food, medicine, insect bites or latex. Your doctor may prescribe an Epipen for a severe allergy. This medication should be used at the earliest sign of severe allergy. You should always carry it with you. G When a severe asthma attack or allergy attack occurs, get help and call 911. A severe asthma attack can include: Difficulty talking. Blue-colored lips and/or grayishcolored skin. Using neck or chest muscles to breathe. Coughing that leads to vomiting. Signs of a severe allergy attack include: Itching or hives within minutes. Swelling of the lips, face and tongue. Difficulty swallowing or drooling. Dizziness or fainting. Vomiting. Trouble breathing. Asthma Triggers An asthma trigger sets off your asthma Here are some triggers and how to avoid or control them. Allergens Animal Dander - dried saliva on fur or feathers of pets can increase asthma symptoms. Dust Mites - tiny bugs found in mattresses and pillows, cloth furniture, carpeting. Many people with asthma react to dust mite droppings. Keep pets outdoors if possible; keep them out of the bedroom and away from carpeted surfaces. Keep bedroom doors closed. Keep pets away from cloth furniture and carpets. Bathe animals often. Consider shorthaired or non-shedding pets. Cover mattresses and pillows with allergy-proof covers. Wash sheets, pillowcases and blankets weekly in hot water that is at least 130ºF. Keep humidity in house low. Vacuum often with a HEPA (high efficiency particulate air) filter. Damp-mop non-carpeted floors frequently. Replace curtains or drapes with blinds, if possible. Keep stuffed toys to a minimum and wash frequently. 3

8 Cockroaches - some people with asthma react to cockroach droppings. Use closed containers for food not stored in the refrigerator. Keep garbage in closed container outside of house. Use pesticides cautiously and when asthma patient is out of house. Keep all poison bait away from children and pets. Pollen - budding trees, grass and weeds may affect asthma symptoms. Stay indoors when pollen count is high and during warmest part of the day. Use air conditioning for filtering these particles from household air. Shower and shampoo hair before going to bed. Avoid hanging laundry outside. Molds - damp or moist areas of your home promote mold growth. Use exhaust fan when showering. Check for and repair water leaks in basements, inside walls and under sinks. Use household cleaners that are safe for the environment. Outdoor mold grows on falling leaves. Avoid raking leaves or wear a mask while raking. Eliminate areas of standing water outside. This will decrease mold growth. Irritants Smoke - any form of smoke: tobacco, wood stove, campfire or barbecue can trigger asthma symptoms. If you smoke - quit. If a loved one smokes - encourage him or her to quit. Avoid secondhand smoke in automobiles, homes and other enclosed areas. Limit exposure to wood stoves and fireplaces. Make sure they are well vented. Do not store wood inside, which will also promote mold growth. Air irritants - small, invisible particles in the air may cause irritation in your airways. Stay indoors, close windows and use air conditioning during ozone alerts. Avoid using perfume, scented hair products, air fresheners and strongsmelling household cleaners. Avoid burning scented candles. Weather factors - weather extremes may affect your asthma. Wear a scarf over nose and mouth during cold, dry weather. Limit time outdoors during high humidity and ozone alerts. Exercise - exercise can help asthma and can cause flare-ups. Speak with your health care provider before starting an exercise program. Provider may recommend medication use prior to activity. Try warming up for exercise, such as slow walking. Avoid outdoor exercise during extreme weather (high humidity, high temperature, frigid air). Carry your rescue inhaler at all times. Cold and respiratory infections - can increase lung inflammation, making it difficult to breathe. Prevention is the key. Talk with your provider about getting an annual flu shot and a pneumonia shot every 10 years. Help prevent viral respiratory infection by: Frequent hand washing. Cover your mouth and nose when sneezing or coughing. Disinfecting doorknobs, railings and shared items, such as telephones, keyboards and computer equipment. Avoid sharing drinking and eating utensils. Other asthma triggers include Reflux - indigestion or heartburn. Emotions - laughing, crying, anger, anxiety or stress. Work place triggers - asthma triggers in the work place may be a result of fumes from chemicals, paint, cleaning products, exhaust, cooking and baking products. Also particles or smells from carpeting, furniture and newly painted or remodeled areas. Report increased asthma symptoms at work to your supervisor and health care provider. Wear a mask when chemicals are being used. 4

9 Asthma Treatment It is recommended that a specialist (allergist or pulmonologist) be seen if: G Your asthma is not controlled. G Your asthma episodes result in emergency room visits or hospital admissions. G You need more education about asthma. G You need more testing. G You are not meeting your therapy goals in three to six months. G You have other medical conditions that affect your asthma. G An asthma specialist may try other treatment and testing options such as: Pulmonary functioning tests. Skin prick test for allergies. Blood test for allergies. Medications. Medications Medications: How do they work? Even though there is no cure for asthma, it can be controlled. The goal: G reduce the need to use your rescue inhaler. G prevent asthma attacks from occurring. Metered-dose inhaler devices, (MDIs) are made to release a premeasured amount of medication. MDIs deliver commonly used asthma medication to help open up the airways and make breathing easier. They are especially important for delivering quick relief medication in case of an asthma attack. MDIs are also used to deliver long-term control medications, anti-inflammatory medication and longacting bronchodilators. Two basic categories of medications: Category 1 Corticosteroid medication: Control medications. G They help to prevent and reduce the swelling in your air tubes and decrease the mucous. G You will not feel anything happening immediately after using your controller medication, but with continued use, you will notice fewer symptoms of asthma and less frequent need to use your quick reliever medication. G It is important that you take your controller medication everyday as prescribed for maximum benefit. G Never use your controller medications to relieve a sudden asthma attack. Side effects are uncommon: Oral thrush (yeast infection in the mouth). Hoarseness. Sore throat. Nervousness. Nausea. Having difficulty sleeping. Tell your doctor if you feel like this. He or she may want to change your dose or try a different medication. Be sure to rinse your mouth out after using your medication to prevent thrush and reduce hoarseness. Some people do not like it when they hear a medication has a steroid in it. Corticosteroids are not the steroids used by athletes. Those steroids are called anabolic steroids. Corticosteroids are safe to take for your asthma. Use of high-dose inhaled corticosteroids. Parents may worry about the effect on growth rate in their children if they are on these medications long term, but severe asthma that is uncontrolled can also reduce growth. Elderly patients who have been on high-dose inhaled corticosteroids may experience changes in their bone density and skin thickness. 5

10 These side effects are rare and less likely than those of oral steroids. Leukotriene antagonists: On occasion, people are put on these mildly anti-inflammatory medications. G Prevent airways from swelling when they come in contact with an asthma trigger. G These non-steroids can also help prevent asthma caused by exercise. Long-acting beta 2 agonists - Should not be used as a quick relief medication for an asthma attack. G Should not be taken without an inhaled corticosteroid. G Helps control daily symptoms of asthma, including nighttime asthma. G Can be used to prevent asthma induced by exercise. G There are commercially available inhalers that contain both an inhaled corticosteroid and a long-acting beta 2 agonist in one inhaler Oral corticosteroids (not anabolic steroids) - The hospital or your doctor may put you on this medication short-term to help get your asthma back under control quickly. Used as short-term treatment when you have a severe asthma attack. Quickly reduces inflammation. Category 2 Quick relief medications Short-acting bronchodilators - Rescue medication. G Help to stop an asthma attack after it has started. G Open airways by relaxing muscles that tighten the airways during an asthma attack. G Help prevent expected asthma attacks caused by exercise. Side Effects: Nervousness. Rapid heart rate. 6 Frequently Asked Questions About Controller Rescue Asthma Medications: Medication Medication Will I feel an immediate relief after using my inhaler? No Yes Is this medication used to stop an asthma attack? No Yes Can this medication cure my asthma? No No Can this medication be taken daily? Yes No Can I use this medication before I exercise? No Yes Will this medication help decrease swelling Yes No and mucous? Should I prime my inhaler first before using it? Yes Yes Dry-powdered inhaler: These inhalers release a fine dry powder with a quick and steady deep breath. There is no propellant to deliver the medication. These devices are dependent on the force of your inhalation to get the medication into your lungs. Side effects: Usually minor. Because it is a powder, much of the medication is left in the mouth and throat as you breathe it in, giving you a bad taste and even a little irritation to the tongue and throat. Rinsing your mouth out after every use will help eliminate this. You may also end up swallowing some of the medication that remains after rinsing, which can cause a minor upset stomach or heartburn. If this should occur, be sure to let your doctor know. Please note that many decongestants are not recommended for use in children. These medications should not be used in children under 2 years of age. Most products contain labels stating the medication should not be used for children under 4 or 6 years of age. A more common side effect is a yeast infection or oral thrush in the mouth and throat, which appears as a white coating of the mouth and throat. This is easily treated by your doctor. Allergy medication: Antihistamines: Relieve sneezing, itching and runny nose. They work best if taken routinely during the allergy season. They block the effect of histamine (a substance made by the body during an allergic reaction). Decongestants: Work by narrowing blood vessels and reducing fluid in the affected area, which helps clear congestion and improve breathing. Oral decongestants relieve stuffy nose and drainage. Please note that many decongestants are not recommended for use in children. These medications should not be used in children under 2 years of age. Most products contain labels stating the medication should not be used for children under 4 or 6 years of age. Leukotriene [loo-kuh-trahy-een] modifiers: Are not steroid medications but are long-term controller medications. They help reduce airway inflammation and swelling, decrease the amount of mucous and open the airways. The month before allergy season is the best time to start taking allergy medication. Your doctor may recommend an allergy medication to help control your symptoms, or he may recommend an over-the-counter allergy medication.

11 Inhaler/Nebulizer How to use an inhaler A metered dose inhaler, MDI, is a device to deliver asthma medication to your lungs. Prime If this is your first time using an inhaler, you will need to prime it. You should also prime an inhaler if it has been longer than two weeks since you last used it. 1. Take the cap off the mouthpiece. 2. Shake the inhaler for 5 seconds. 3. Press down on the canister, spaying the medication into the air two times (away from your face). Look to see if a fine mist has been released. Regular use 1. Remove cap and hold inhaler upright. 2. Shake inhaler five to 10 times to mix medicine. 3. Attach spacer if indicated by your doctor. 4. Take a deep breath, then exhale completely. 5. Place the mouthpiece in your mouth if using the closed-mouth method. 6. Close your lips around it tightly. 7. When using the open-mouth method, place inhaler 2 inches from open mouth. 8. Begin to breathe in slowly while you press down to release a puff of medication. 9. Hold your breath for five to ten seconds. This will allow medication to get deep into your lungs. 10. Breathe out slowly. 11. Repeat puffs as directed. Wait two to five minutes between puffs. How to use a spacer Your doctor may recommend using a spacer. It attaches to the inhaler. It holds the medication in a chamber. A spacer is recommended for use with all inhaled corticosteroids. It is also suggested for use with all MDI inhalers. Ask your doctor what is best for you. 1. Take deep breaths to inhale the dose of medication and hold your breath. 2. Repeat for second puff. Care of a metered dose inhaler It is important to keep your inhaler clean and ready for use. 1. Remove mouthpiece from canister. Rinse after each use. 2. If the mouthpiece or spacer becomes dirty, wash with mild soap and warm water. 3. Rinse well. 4. Always allow it to air dry completely. 5. Store inhaler in a cool dry place. Avoid placing it in sunlight. Do not store in car or near open flames. How to use dry powder diskus-type inhaler 1. The diskus inhaler is closed when you open original package. 2. An indicator may tell you how many doses are left. 3. Diskus inhalers may have an alert when doses are getting low. 4. Numbers will appear in red when you have about five doses left. Taking a dose Open 1. Hold inhaler in one hand. 2. Place thumb of the other hand on the thumb grip. 3. Push your thumb away from you until mouthpiece appears. 4. When you have pushed as far as you can, it will snap into place. Click 1. Hold inhaler level and flat. 2. Mouthpiece should be toward you. 3. Slide the lever away from you until it clicks. 4. Inhaler is now ready for use. Inhale 1. Take a deep, cleansing breath. Exhale fully. 2. Hold inhaler level. 3. Place mouthpiece to your lips. 4. Breathe in fast and deeply. 5. Take inhaler away from your mouth. 6. Hold your breath for as long as you can at least 10 seconds. 7. The medication from this inhaler is a dry powder. 8. You may be able to feel or taste it. 9. Rinse your mouth with warm water and spit it out. 7

12 Close the inhaler when finished. 1. Place thumb on thumb grip. Slide it toward you all the way. 2. It will snap shut. 3. The inhaler is now ready for your next dose. Important points for dry powder inhaler DO Use inhaler in flat position. Rinse your mouth after use. Spit out rinse water. Store inhaler in a dry place. DON T Breathe into this inhaler. Take inhaler apart. Use with a spacer. Wash mouthpiece of inhaler. Take an extra dose if you do not taste or feel medication. How to use a twist-type inhaler Some twist-type inhalers need to be primed the first time they are used. Prime 1. Hold inhaler upright. 2. Grasp colored part (bottom) in one hand. 3. Grasp top of inhaler and lift off. 4. Grasp inhaler on bottom, colored part in one hand. 5. Grasp top of inhaler in the middle with the other hand. 6. Twist bottom as far as it will go to right and then to the left. 7. Then twist it in the other direction until it clicks. 8. Twist back and forth again. 9. Priming is complete. Remember when using dry powder or twist inhalers: DO Always hold inhaler level. Always hold inhaler upright when priming or loading. Always rinse mouth with warm water after use. This will help prevent fungal infections of the mouth. Wipe mouthpiece dry. Store in a dry place. Use 1. Hold inhaler in upright position. 2. Twist bottom of inhaler all the way to the right and back to the left. 3. Inhaler will click. 4. This loads a dose of medication. 5. Breathe out completely facing away from the inhaler. DON T Shake inhaler after loading dose. Exhale into inhaler. Swallow water you have rinsed your mouth with. Prime inhaler after the first use. Hold inhaler at the top of the mouthpiece. 6. Close lips around mouthpiece. 7. Inhale as deeply and forcefully as you can. 8. Remove from mouth and exhale. 9. Replace cover. 10. Rinse mouth with warm water and spit out. 8

13 How to use a nebulizer A nebulizer uses air to make a mist of your asthma medication. Breathe the mist into your lungs. 1. Your medicine may already be mixed. 2. Open it and place in the cup. 3. Attach the mouthpiece to the cup. 4. Attach these to the tubing of the machine. 5. Place mouthpiece in mouth. 6. If you use a mask, place it over your mouth and nose. 7. Turn on the machine. 8. Take deep, slow breaths through your mouth. 9. Try to hold each breath for two seconds. 10. Continue until medication is gone. This will be about 10 minutes. Care of a nebulizer Cleaning your nebulizer is very important. This helps prevent infections. Proper cleaning also makes the machine last longer. 1. Remove mouthpiece or mask from the cup. 2. Remove tubing. 3. Wash all parts, except tubing and machine. Use mild dish soap and warm water. 4. Rinse completely with warm water. 5. Shake off excess water. 6. Place on dry, clean cloth or paper towel. 7. Allow to air dry. 8. Attach parts and run machine 10 to 20 seconds. This will dry inside of machine. 9. Remove tubing. Store machine and parts in a plastic bag. 19. Twice a week, soak parts (not tubing or machine) in one part distilled white vinegar and two parts water. 11. Soak for 30 minutes. 12. Rinse parts for one minute. 13. Allow to air dry. 14. Put parts together. 15. Run machine 10 to 20 seconds. This will dry inside of machine. 9

14 Peak Flow Meter The peak flow meter is a monitoring device that helps measure how well air is coming out of your lungs. This measurement can be used to find out if you have reduced airflow hours or days before you have an asthma flare-up. This will allow you to use your rescue medication to stop the flare-up quickly. The meter is easy to use. Take a reading before you take your asthma medicine in the late afternoon or early evening. Asthma In School G Most common disease among children. G Leading cause of missed school days. It is very important to have a written asthma action plan from your doctor if your child has persistent asthma. If you use a rescue inhaler only for gym class or other sports, your doctor will write instructions. Always notify the school nurse of any illness.an asthma action plan should include: medications and dosages. asthma symptoms. peak flow readings if used. triggers. Inhaler required before gym or recess. Meet with the school staff yearly to talk about the following: How to use a peak flow meter 1. Hold the meter in your hand. 2. Move the pointer to zero. 3. Stand up. 4. Take a deep breath. 5. Place the meter in your mouth. Seal your lips around the mouthpiece. 6. Blow out as hard and fast as you can. 7. Write down the number at the pointer. 8. Repeat this two more times. 9. Record your best of three tries on your asthma diary. Asthma symptoms and triggers. Your child s ability to recognize symptoms. Emergency phone number for the parent or guardian and doctor. Discuss the school rules for medications. Who would be available to handle asthma symptoms for upcoming field trips? Changes in the classroom, such as new pets (gerbils, hamsters), construction, new cleaning products or classroom supplies (paints, glues, eraser dust). New York state has a law in place that allows children with severe asthma to carry their quick relief medication with them while in school. It is best to talk to your doctor regarding these rules and requirements. The highest reading you can record is called your personal best reading. Your doctor will use this reading for your asthma treatment. 10

15 Asthma In The Work Place Dust (dander) from animals and insects. Dust from wood, latex gloves, flour and poorly cleaned buildings. Mold in damp or water-damaged parts of buildings. Physical stimuli (cold/heat, humidity). Symptoms Refer to Asthma Signs and Symptoms You may be exposed to many different particles at work. Your employer should give you information of possible danger connected to your job. Your employer should keep a healthy work place. Special equipment may be needed to protect you. Report any unhealthy work conditions to your employer. Occupational asthma is worsening of symptoms in workers with a previous history of asthma. A worker with no previous history of asthma can also develop occupational asthma. Aggravated asthma is due to repeated contact to dust and fumes. Being in contact with these triggers is considered an irritation to the lungs. Early diagnosis and treatment may help end symptoms. Some common jobs with allergen or irritant exposure: Office workers. Construction workers, including welders. Janitors and cleaners. Farmers, bakers and grain handlers. Beauty salon workers. Teachers. Triggers: Each person has different triggers that start asthma attacks. Some triggers in the work place may include: Chemicals in paints, cleaning products and other things. Refer to work place triggers on page 4. Patterns of symptoms: Improvement of symptoms occurs during vacations or days off (may take a week or more). Symptoms may occur immediately (less than one hour), delayed (most commonly within two to eight hours after exposure), or at night. Initial symptoms may occur after high-level exposure (for example, chemical spills). Once sensitized, patients with occupational asthma may react to extremely low levels of airborne allergen. What can you do? Let your doctor know about your current job and other jobs you have had. Keep a daily record of your symptoms and asthma attacks. Let your doctor know when your asthma gets better or worse. Avoid triggers. Move to another work area. Wear proper equipment. You should work with your employer to remove yourself from triggers. 11

16 Traveling With Asthma Croup There are important things to do before going away when you have asthma. Your asthma should be controlled. Carry your inhalers and other asthma medications with you at all times. Bring a list of medications and dosages. Bring your doctor s and pharmacy name and phone numbers. Take a copy of your asthma action plan. Have enough medications to last the whole trip. Let family or friends know triggers ahead of time. Find out pollen counts and smog levels. While traveling, your living space should be: Smoke-free. Pet-free. Dusted. Vacuumed. Aired out. Remember that you may be in contact with triggers when using public transportation. Drink plenty of fluids when the air is dry to help prevent symptoms. Traveling by car Before traveling, run the air conditioner or heater for 10 minutes while the windows are open. This will help remove any odors or dust in the vents. Traveling by plane Check to see that it is a non-smoking flight (outside of the U.S.) Make sure that all medications have the original prescription label. What is it: G Inflammation in the upper airways voice box and windpipe. G Caused by a virus. G Most common in children (six months to three years). G Occurs in the fall/early winter. G Contagious through coughing, sneezing and close contact. Signs and symptoms: G Can start as a common cold, stuffy, runny nose and fever. G Child becomes hoarse with a loud, harsh barking cough like a barking seal. G Worse at night and when the child is upset or crying. G You may hear a high-pitched or squeaking noise as the child inhales (called stridor). G Breathing may be very fast and may have retractions. G Lasts two to five days. G Dehydration can occur. Resources - Centers for Disease Control and Prevention - New York State Department of Health - National Heart, Lung and Blood Institute - American Lung Association Treatment: G Try to stay calm and soothe your child. G Fill bathroom with steam and sit for 10 minutes, breathing in moist air. G Breathing cool, night air may help. G Humidifier in the child s room at night. G Do not smoke. G Keep child hydrated. G If symptoms do not improve in 30 minutes, call the doctor. 12

17 Asthma Diary This is a record of your peak flow readings, symptoms and medications. This log helps you and your doctor manage your asthma. Complete this form and take it to your next doctor s visit. Week of: My personal best is My green zone is liters per second (80% to 100% of my personal best*) My yellow zone is liters per second (50% to less than 88% of my personal best*) My red zone is less than liters per second (less than 50% of my personal best*) * To figure out 80% of personal best peak flow, multiply your personal best by To figure out 50% of personal best peak flow, multiply your personal best by My current long-term medications are: Date AM PM peak flow Trigger Symptoms Quick-relief medication Red zone visit and response to doctor Green Yellow Red or hospital? This information does not replace the advice of a doctor. 13

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