With so many variables, most doctors recommend having a personal asthma action plan. This plan must be understood and followed by everyone who cares for the child--babysitters, day care staff, teachers, school nurses and camp counselors.
If all of that is not complicated enough, there is more. Most of the long-term and the quick relief medications involve not just popping a pill but using specialized devices and equipment--inhalers, spacers, discuses, compressors, peak flow meters, spirometers, nebulizers and masks.
There are many steps involved in using most of these devices properly. And a mistake means the child is not getting the proper dose and may be at risk of severe symptoms.
When emergency department staff see asthmatic children being brought in repeatedly, it's pretty easy to figure out that at least some of these children either have no long-term Asthma Action Plan or else it is not being followed as closely as it should be.
The IMPACT DC (Improving Pediatric Asthma Care in The District of Columbia) program was based on such an observation. Doctors found that very few of the children being brought in to the emergency department were going back to primary care providers who could help them re-establish daily control.
The Asthma Clinic that was established as a result made substantial use of asthma educators, reviewing with families the basics of asthma care and the need for a coordinated treatment approach involving the family, school nurses, pharmacists and subspeciality doctors and nurses.
A study found that subjects at the clinic had dramatically fewer emergency department visits, significantly better use of daily controller medications and dramatic improvements in asthma-related quality of life.
The clinic was considered not an end in itself but a means to an end--greater understanding by the patient and his or her family about the importance of day-to-day self management in order to prevent short-term flare-ups.
It all starts with education -- how and why to monitor your breathing and take control medications even when you don't have symptoms. The many devices used by the patient are designed to make asthma control easier, but they do so only if they are used properly. The best way to learn is to have a health professional demonstrate proper use, then have you demonstrate back to them to make sure you have it right.
As frightening as the symptoms may be when an attack occurs, it's possible to go through life with few emergencies and a normal quality of life.
This information was submitted by Northeastern Vermont Regional Hospital in St. Johnsbury and is meant to complement, not replace, the advice and care you receive from your health care provider.