Asthma Control Made Easy 10 Steps to Asthma Control Sherri Washington, RN, BSN, CCRN, AE-C
Objectives According to Dr. Thomas F Plaut, the presence of symptoms or the need for emergency care is usually due to an incomplete understanding of asthma (2005) so my objective is to give you a complete understanding of asthma in 10 steps!
Step 1-What is it? Lung tubes (bronchioles, airways) are over- reactive to: o Allergens o Triggers*** o Pollutants
Causing: Muscles around airways to tighten and inflammation inside of airways
Step 2-Four Signs of Asthma Coughing (usually dry) Wheezing (maybe; whistling sound) Chest tightness (retractions, sucking in ) Shortness of breath (fast breathing, worried look)
Question- If you have asthma as a child, you will grow out of it. If you are not wheezing, it is NOT an asthma attack.
Step 3-What are triggers anyway? Illness? Cold air? Exercise? Russian olive trees? Perfume? Smoke?
How do you figure it out? The Obvious-every time I get a cold Trial and error-smoky casino; Grandma wears a lot of perfume Immunocap-Blood test: pets, insects, foods, plants, etc.
Trigger Avoidance WILL result in less symptoms and less medication use KNOWING your triggers and avoiding them WILL result in less symptoms and less medication use However, lets talk about pets and smoking
Question- An asthma attack can last days. Breathing in cold air can be a trigger for asthma.
Step 4-Basic Medications Rescue (quick relief) -relaxes those muscles tightening around the lung tubes (bronchioles or airways) -Should only be used less than 2 times a week if you are in control (exception is exercise) -Should not have to purchase more than 4 times a year Does NOTHING for the inflammation!!
Controller (preventer) -different ways of working, but they should reduce or eliminate asthma symptoms -they may: reduce inflammation, they may work on the nerves that tell the muscles to contract, prevent mucous from being produced, change the shape of a receptor site...
Question- You can get hooked on asthma medications. You should only use asthma medications when you are having asthma symptoms.
Step 5-Deliver the Medication Correctly Have good technique (get into airways) Aero-chamber or similar device (guarantees delivery) Hold your breath (6-10) Wait between puffs (allow first dose to get in airways)
Question- You cannot drink milk when you have asthma. You cannot get a flu shot if you have asthma. Raw honey is a proven cure for asthma.
Step 6-Record Keeping Daily symptom diary (assist to find triggers) Rescue medication use diary Peak flow record*** This will illustrate your asthma to your provider
Question- Asthma is the leading cause of kids missing school. If you use your rescue medication more than 2 times a week for a few weeks, you are out of control.
Step 7-Peak Flow Monitor Reflects accurate lung function Can predict an asthma attack Objective-provides valuable info for provider Used with Asthma Action Plan
320-up Controller daily 400 Best rescue 200-320 Rescue, prednisone 200- below 911
Question- No one dies from asthma. Some of the medications for asthma are dangerous and can cause permanent damage. When you feel fine and have no physical symptoms, your asthma has gone away.
Step 8- Good Decision Making Asthma Action Plan- tells you what to do! Based upon knowledge of the 4 asthma signs (what does blue lips and blue fingernails mean?) When to use rescue medication or when to schedule appointment with provider
Question- You can cure asthma by moving to a dry climate. People with asthma need to get disability and stay home from work. Asthma attacks occur suddenly, without warning.
Step 9-Appropriate Expectations No missed days of school No missed days of work Full participation in PE at school Full participation in team sports, play Everyone concerned gets to sleep through the night (all family members)
Question- Asthma is all in your head and you can make up your mind not to have it. If you relax and don't over-react every time you feel short of breath, you won t have an attack.
Step 10-The Right Provider Accessibility Lung Function testing at every visit Asks about your symptoms Monitors how medication is used
Question- You cannot play outside or participate in school when you have asthma. Severe asthma can only be controlled by going to the Emergency Room.
Questions? And Thank you!
References Fanta, C., Carter, E., Stieb, E., & Haver, K. (2007). The Asthma Educator s Handbook. New York: McGraw Hill Plaut, T. (2005). Basic Elements of Asthma Education. Retrieved from http://pedipress.com/dm_basic_elements_edu. html Sussman, R. (2013). Implementing guideline based strategies to improve adherence in asthma patients. Retrieved from http://namcp.org/journals/fall13/sussman%20as thma.pdf