Asthma Education - Cumming School of Medicine · 2020-03-16 · child has asthma. The information...

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Asthma Education Community Pediatric Asthma Service www.ucalgary.ca/icancontrolasthma 403-943-9139 1

Transcript of Asthma Education - Cumming School of Medicine · 2020-03-16 · child has asthma. The information...

Page 1: Asthma Education - Cumming School of Medicine · 2020-03-16 · child has asthma. The information you share with health professionals helps us understand if it is asthma. These are

Asthma Education

Community Pediatric Asthma Servicewww.ucalgary.ca/icancontrolasthma

403-943-9139

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SYMPTOMSCough

WheezeShort of Breath

Tight Chest

PATIENT HISTORYAllergiesEczema

Family History

RESPONSE TOMEDICINE

2 - 3 days with inhaled corticosteroid medicine

Significant difference in 2 weeks ORNoticeable change in symptoms with

reliever medicine

BREATHING TEST(SPIROMETRY)

Children 6 years and olderTest of your lung health on the day of

the test

DiagnosisStory

NoYes

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Recognize Asthma

• Asthma symptoms can “come and go” and change• Asthma makes it hard to breath• Asthma can cause coughing, wheezing, shortness of

breath or tightness in the chest

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How Asthma Affects the Lungs

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• Airways in the lungs become swollen• Mucous is produced and builds up in the airways• Swelling and mucous blocks the airways• Muscles around the airways tighten and squeeze the

airways

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Not all coughs are asthma.Don’t forget the nose.

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• Asthma gets worse when you are exposed to your triggers

• Identify and try to avoid your triggers to get and keep control

What can trigger asthma?

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Reliever Medication

• Comes in a blue ‘puffer’• Used for immediate relief of asthma symptoms: cough/

wheeze/tight chest/shortness of breath• Very safe and can be used when you are not sure• Using it more than two times in a week could be a sign of

poorly controlled asthma• Most children, even 6 year olds, can use their own puffer• The puffer should be easy to get - not at home or in the

school office (in your own locker or backpack)

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Preventer/Controller Medication• These puffers are usually NOT blue• These medicines should be taken every day at home,

even when you have no symptoms to keep your asthma well controlled

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Medication and Devices

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Medication Delivery

• A spacing device should be used with every ‘puffer’

• A spacer makes sure the most medicine gets into your lungs

Puffer with spacer

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Why use a Spacer?

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What is an Asthma Action Plan?

• An Asthma Action Plan shows you how to monitor asthma and adjust asthma medicines

• Every child with asthma should have an Asthma Action Plan written by a health care professional

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Warning Signs of Poorly Controlled Asthma

• A cough that never goes away• No energy to exercise• Having asthma symptoms or needing your blue

inhaler more than two times in a week• Waking in the night with asthma symptoms

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Children and Exercise

When asthma is well controlled, children can:– Join in school activities including physical education,

recess, field trips and sports day– Play as much as they want with their friends– Play competitive sports

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The Good News About Asthma

• Professional and Olympic athletes have asthma. Having asthma should not prevent children from doing anything they want to do

• Asthma can be treated and managed and should not interfere with any of the activities of daily life –playing, sleeping, learning, sports, exercise, having fun!

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Need information on COVID-19?

With so much information coming to us about the COVID-19 virus, the following links contain reliable, updated information from Alberta Health Services. • Updates on the COVID-19 virus• COVID-19 Self Assessment Tool: Use this tool to help determine

whether you should be tested for COVID-19

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Contact us

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• Asthma Education is available with a referral from your family doctor or pharmacist

• For more information call the Community Pediatric Asthma Service at 403-943-9139 or visit our website at:

www.ucalgary.ca/icancontrolasthma

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Yes No Not at all

My Name: ___________________________________________________ Date: _____________________________

What Matters To Me: ______________________________________________________________________________

smoke colds animals pollens mold dust strong smells weather changes strong emotions other______________

Circle My Usual Symptoms: Cough / Wheeze / Short of Breath / Tight Chest / Other ________________________

Circle My

Triggers

No symptoms, regular activitiesIs my asthma well controlled?

What to do:

Cough, wheeze, short of breath, tight chest, colds, allergies

Very short of breath, trouble speaking, blue/grey lips/fingernails

1. Daytime symptoms

2. Nighttime symptoms

3. Reliever use (other than if prescribed for exercise)

4. Physical activity or exercise

5. Can go to school or work

Controller: Use EVERY DAY to control asthma and prevent flare-ups.

1. __________________________________________(name / colour / strength)

2. __________________________________________(name / colour / strength)

3. __________________________________________(name / colour / strength)

4. __________________________________________(name / colour / strength)

Continue this dose for _______________

1. Take _________________ qAM qPM ( amount )

2. Take _________________ qAM qPM ( amount )

3. Take _________________ qAM qPM ( amount )

4. Take _________________ qAM qPM ( amount )

1. Take _________________ qAM qPM ( amount )

2. Take _________________ qAM qPM ( amount )

3. Take _________________ qAM qPM ( amount )

4. Take _________________ qAM qPM ( amount )

Take reliever before exercise? q Yes

Take __________________ as needed (# of puffs)

Continue this dose for _______________

Take __________________ as needed (# of puffs)

Reliever: Quickly and temporarily helps asthma symptoms.

____________________________________________(name / colour / strength)

None

None

None

Normal

Yes

3 or more times a week

1 or more times a week

3 or more times a week

Limited

Maybe

Continuous & getting worse

Continuous & getting worse

Relief for less than 3 to 4 hours

Very limited

No

STAY CONTROLLED & AVOID MY TRIGGERS

TAKE ACTIONSee a doctor if no improvement in ____ days

GET HELP

Completed with: _____________________________________________________ I share and complete this plan with my healthcare team.

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Take 5 to 10 puffs of my reliever medicine every 10 to 20 minutes while I get help.

Notes:

Patients can view this Asthma Action Plan at: www.myhealth.alberta.ca Clinicians can download a fillable version of this Asthma Action Plan at: www.ucalgary.ca/icancontrolasthma

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1CPAS 263 www.ucalgary.ca/icancontrolasthma for more asthma information and videos Reviewed May 2019

Does My Child Have Asthma?“Does my child have asthma?” is a common question families ask. Asthma can make it hard to breathe and can cause coughing, wheezing, shortness of breath or tightness in your chest. These things we see and feel are called symptoms. Asthma symptoms can come and go, making it hard to know if a child has asthma.

It may take weeks, months or even years to confirm asthma, but there are ways to help us know if it is more likely or less likely that a child has asthma. The information you share with health professionals helps us understand if it is asthma. These are the 5 important things to think about:

The information below includes ideas to help you learn what to look for and what to write down to share with your doctor or asthma educator.

Visit our website at www.ucalgary.ca/icancontrolasthma for more information and other resources.

1. SYMPTOMS Common asthma symptoms include:

• Cough – Cough may come and go. It can be worse during the middle of the night. Some children cough so hard they struggle to breath or throw up

• Wheeze – This is a whistling sound you hear when your child takes a breath in or out. Visit our website to hear wheezing (see “Videos” tab ➜ ”A Little Asthma Story”)

• Tight Chest – Some children say asthma feels like being squeezed or having something heavy sitting on your chest. This can be hard for children to describe

• Shortness of Breath – Children often say they cannot get a full breath in. They may need to stop playing to catch their breath or they can’t keep up with their friends when running or playing

2. TRIGGERS Triggers can cause asthma symptoms or may make the symptoms you already have worse. Triggers are different for everyone.

Some common asthma triggers include:

• Colds/Flu – the most common trigger• Allergies – animals, pollen, mold, dust• Emotions/Stress• Environment – strong smells, weather changes• Exercise/Play

1. SYMPTOMS

2. TRIGGERS

3. MEDICAL HISTORY

4. RESPONSE TO MEDICINE

5. BREATHING TESTS (when a child is about 6 years old)

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3. HISTORY It is important to share your child’s medical history with a healthcare professional:

• Patient History – Children who have asthma symptoms or hospital visits for breathing trouble are more likely to have asthma. Children who have allergies or eczema are also more likely to have asthma

• Family History – Children who come from families with asthma or allergic conditions (such as eczema, hay fever and even food allergies) are more likely to have asthma

4. RESPONSE TO MEDICATION If your child has a pattern of symptoms that look like asthma, they may be given a trial of asthma medicine. Asthma medicine must be

taken properly to work. Visit our website to watch videos on how to take your asthma medicines (Click “Devices” tab).

There are two different types of asthma medicine:

Relievers• These puffers are blue and give temporary relief of asthma symptoms

• They should work quickly and relieve symptom for 3 or 4 hours

• Be sure to tell your child’s doctor if this medicine is NOT helping

Controllers or Preventers• These medicines are usually orange, red or brown. They control asthma and help prevent symptoms

• These medicines must be used every day for them to work and it often takes 2 weeks or more to have the best effect

• If your child was given a puffer at the hospital, it is important that you see your family doctor before stopping this medicine

5. BREATHING TESTS • When children are about 6 years old, they can do a simple breathing test called spirometry. Spirometry is only one part of the

overall picture we build to decide if a child has asthma

• Since asthma symptoms come and go, the breathing test only tells us about the lungs on the day the test is done. This means a normal breathing test does not rule out asthma

OTHER THINGS TO THINK ABOUT• Asthma can be diagnosed at any age. Watch for asthma symptoms and see if taking asthma medicine relieves those symptoms

• Children who regularly have asthma symptoms are treated with puffers to lessen the impact of colds. Research shows that half of these children will not have asthma by the time they reach school age

• Finally, don’t be confused by words like reactive airway disease, wheezy bronchitis, happy wheezer and bronchospasm. These are just words some people use to describe asthma symptoms

If your child does have asthma, the good news is that asthma can be well controlled and should not prevent children from doing anything they want to do!

CPAS 263 www.ucalgary.ca/icancontrolasthma for more asthma information and videos Reviewed May 2019

This information is provided by the Community Pediatric Asthma Service, a program to help children and families learn to control asthma.

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Why Should I Give My Child Asthma Medicine?by Dr. Mary Noseworthy & the Community Pediatric Asthma Service

Parents worry about giving their children medicineThis information explains what asthma medicine is for and what can happen if you do not take it

Asthma can make it hard to breathe. Sometimes it might seem like everything is normal, but this can change quickly. The doctor may try asthma medicine when a child has one or more of these breathing problems:

• coughing that doesn’t go away after a cold, especially during the night• coughing or getting tired easily when running• wheezing – a whistling sound when they breathe • finding it hard to take a breath

If your child’s asthma is well controlled and they have no breathing problems, do not stop giving them their asthma medicine – this medicine is helping to keep them well. Talk to your doctor before you stop giving asthma medicine.

WHAT DOES ASTHMA MEDICINE DO?Reliever Medicine (usually a blue puffer): Reliever medicine works quickly to make breathing easier, but it only last for a few hours and it does not get rid of swelling. Reliever medicine can cause shaky hands or a faster heart rate, but these things are not harmful and only last for a short time.

Controller Medicine (usually a brown, red or orange puffer): Controller medicine (corticosteroids) works on calming the lungs and getting rid of swelling so breathing problems get better. Controllers are safe to take every day because they go right into the lungs and are used in small amounts. Take a drink, rinse your mouth or brush your teeth after you take it and you should not have any trouble.

In an emergency, corticosteroids are given at a much higher dose than they usually are – often as a liquid or pill, to quickly improve breathing problems. Because this medicine travels through the whole body and not just the lungs, it may affect a child’s mood. Your doctor will talk to you about any concerns they might have about your use of this medicine.

Using corticosteroid puffers every day is the best way we know to prevent breathing problems and emergency visits or hospital stays.

WHAT IF I DON’T GIVE THE ASTHMA MEDICINE?If children don’t get their asthma medicine, you could notice:

• Poor sleep because of coughing• Missing school because of breathing problems• Not being able to keep up with their friends at play or sports• Not growing as much as you expect because so much energy is spent trying to breathe• More emergency visits or hospital stays because of breathing problems

If you have any worries about asthma medicine, talk to your doctor, pharmacist, nurse or asthma educator. Following your Asthma Action Plan and using asthma medicine every day is the best way we know to make sure children with asthma have no breathing problems.

CPAS 234 www.ucalgary.ca/icancontrolasthma Content review: September 2019

This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. If you have specific questions, please consult your doctor or appropriate healthcare professional.

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CPAS 203 Patient History April 26, 2018

• PLEASE remember to bring this completed form to your asthma education appointment with all your asthma and

allergy medicines/devices, even if you are not taking them right now• Fill out this form from the Patients Point of View

1. Have you ever been told that you have asthma? No Yes. When? _________________________

2. I feel I can manage my breathing/asthma symptoms: Very well Okay Not at all

3. How can we best help you in your education appointment today? Help me learn if I do have asthma Help me understand my asthma better Explain asthma control Explain how asthma medicines work Other _______________________________________________

4. What kinds of things do you wish you could change/fix about your breathing/asthma? Sleep through the night No missed school/work No visible signs of asthma No emergency visits No asthma attacks Exercise, play or sports without my asthma bothering me Other______________________________________________________________________________________

5. Do you worry about having asthma? No Yes. Why?____________________________________________

6. How often do you have breathing problems such as cough, wheeze or tight chest? Rarely 1-3 times/week 4 or more times/week with physical activity with colds/flu

7. Do you experience cough, wheeze or tight chest during the night? No Yes Only with colds/flu

8. Does your breathing interfere with any kind of activity? No Yes. Describe ___________________________Does the reliever/blue puffer help? No Yes Sometimes

9. How many colds/flu did you have in the last 12 months? _______ How many caused breathing problems?_________

10. How many days of school/work have been missed in the last school year due to breathing problems?_______________

11. How many times a week do you use your reliever/blue puffer? ________________________

12. Does asthma interfere with your normal activities? Never Sometimes Usually

13. Is there a time of year when your asthma seems to bother you more? No Yes Fall Winter Spring Summer

14. Do you have itchy, red/watery eyes, sneezing, or stuffy/runny nose at any time of the year?

No Yes What symptoms and when?______________________________________________

15. Do you: Mouth breathe Snore Have frequent sinus infections Have frequent ear infections

16. Do you have: Asthma Allergies Eczema Hay fever Hives Do your family members have:Mother Asthma Allergies Eczema Hay fever Hives Father Asthma Allergies Eczema Hay fever Hives Brothers/Sisters Asthma Allergies Eczema Hay fever Hives

PATIENT HISTORY FORMCOMMUNITY PEDIATRIC ASTHMA SERVICE

Patient Name ______________________________

RHRN _______________________________

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CPAS 203 Patient History April 26, 2018

17. Are you around animals? No Yes Which ones: Cats Dogs Other _____________________ When and where? ______________________________________________________________________________

18. Have you ever been tested for allergies? If so when?______________________________________________ No, but I think I am bothered by: __________________ _______________ _________________ Yes, my known allergens include: __________________ _______________ _________________ Have you ever had anaphylaxis? No Yes. To what?______________________ Do you carry an Epi-Pen? No Yes Do you know how to use it? No Yes

19. What things seem to make your breathing/asthma worse? Colds/flu Animals Dust Mold Pollen Cold air/Weather changes Pollution Strong smells Exercise Smoke Emotions Don’t know Other (explain)

20. Are you exposed to second-hand smoke at home or in the car? No Yes

21. Do you smoke? No Yes If yes, have you tried quitting? No Yes

22. How many times have you been seen urgently for your breathing/asthma in the last 12 months? ________

23. Have you had a hospital stay for your breathing/asthma in the last 12 months? No Yes When? __________

24. Have you taken oral steroids (pills or liquid) for your breathing/asthma in the last 12 months?

(Examples: Prednisone, Pediapred, Dexamethasone) No Yes. How many times? __________________ 25. List all the medicines you have for your asthma and allergies. Bring ALL asthma and allergy medicines and

devices you have to your education session, even if you are not taking them right now.

When are you more likely to miss a dose of medication? Morning Evening

26. Who prescribes your breathing/asthma medication and how often do you see them? _________________________ 27. Do you take any other therapies for your asthma or allergies? No Yes Acupuncture Naturopathy Chiropractic Homeopathy Other _________________

28. Do you think you have any side effects or do you have any concerns about your asthma medicine? No Yes. Concerns?_______________________________________________________

29. In rare instances corticosteroids at high doses have caused low cortisol levels (adrenal insufficiency), resulting in fatigue, nausea and vomiting. Has your child had any unexplained instances of these symptoms?

Explain __________________________________________________________________________

30. Do you feel that your asthma symptoms are well controlled by your current treatment? No Yes

31. Is the cost of medication covered by insurance/work benefits? No Yes

Name of Medicine Dose # of

times/day Is the medication used daily, or only when needed

Anything else you want to add?

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CPAS 202 April 26, 2018

Uncontrolled asthma can lead to emergency visits and admission to hospital. See your doctor, asthma educator or pharmacist for more information about how to control your asthma. Know the emergency numbers in your area. In Alberta, Health Link is a 24-hour telephone advice line staffed by experienced nurses. If you have any questions, dial 811 in Alberta.

OTHER THINGS YOU CAN DO: 1. If possible, remove yourself or your child from any known triggers; 2. Sit up. Loosen tight clothing; 3. Make an appointment with your family doctor/pediatrician as soon as possible after an asthma emergency; 4. Visit the “I CAN Control Asthma” website at www.ucalgary.ca/icancontrolasthma for more information about asthma.

This material is for information purposes only. It should not be used in place of medical advice, instruction, and/or treatment. If you have questions, talk with your doctor or appropriate healthcare professional.

SEE YOUR DOCTOR GO TO AN EMERGENCY DEPARTMENT CALL 911

WHAT YOU SEE/FEEL

• If you are using rescue/reliever medicine (often blue) more than 2 times/week

• If the skin at the base of your child’s neck, between the ribs, or below the breastbone pulls in when your child breathes

• If your child has no energy to play or even move around

• Your baby will not eat or drink

• If you have or see symptoms that are very serious- breathing very fast, gasping for breath, trouble speaking, blue-grey lips or fingernails, CALL 911

WHAT TO DO • If your asthma symptoms are getting worse, take your preventer/controller medicine at the highest dose recommended by the doctor

• If you are not getting better within 12 – 24 hours, make an appointment to see a doctor as soon as possible

• Take your rescue/reliever medicine (often blue). This medicine should make breathing easier within 5 - 10 minutes. You should have good relief for 3 - 4 hours

• If the dose needs to be repeated before 3 hours, please go to Emergency

• You know best. If you are worried, go to Emergency

• Stay calm • CALL 911 and give the rescue/reliever

medicine (often blue) every few minutes until help arrives

WHAT USUALLY HAPPENS

• Everyone with asthma should have an Asthma Action Plan. Your plan will help you know how to adjust your medicine to control your asthma

• Make an appointment with your doctor or asthma educator to develop an Asthma Action Plan

• Print a blank copy to take to your doctor from our website: www.ucalgary.ca/icancontrolasthma

• It is normal to have to stay several hours for treatment/observation. You may be admitted to the hospital until your asthma symptoms are in better control

• Along with your regular medicine, you may also be prescribed a short course of oral steroids to help get asthma back in control quickly

• Ask for an Emergency Asthma Action Plan

• You may be referred for asthma education

• Paramedics will treat you • You may have to go to Emergency for more

treatment • It is normal to have to stay several hours for

treatment/observation. You may be admitted to the hospital until your asthma is in better control

WHEN AND WHERE TO GET HELP FOR ASTHMA