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ASTHMA
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Presented by your School Nurse
Asthma
What is Asthma?
Asthma is a chronic respiratory disease.
Inflammation plays a large role.
Inflammation contributes to airflow problems.
When an asthma attack occurs, the muscles of
the bronchial tree become tight and the lining of
the air passages swell, reducing airflow and
producing the characteristic wheezing sound.
Mucous production is increased.
Three levels of asthma
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Mild asthma: symptoms occur no more than
twice a week. The attacks don’t last long, and
they are alleviated quickly with medication.
There are no symptoms between attacks.
Moderate asthma: symptoms occur almost
every day and require an inhaler almost every
time an attack occurs for symptom relief.
Severe: symptoms are present most of the day
every day. They restrict activity and they have
often necessitated a hospital stay.
Several types of asthma
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Adult-onset asthma develops after the age of
twenty. It is less common than asthma in
children, and it affects women more than men.
Exercise-induced asthma involves symptoms
that occur about 5-20 minutes after beginning
an exercise that involves breathing through the
mouth. Activities that require continuous
activity that are played in cold weather are the
most likely trigger for an asthma attack.
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Nocturnal asthma occurs between midnight
and 8 am. It is triggered by allergens in the
home such as dust and pet dander or is caused
by sinus conditions.
Occupational asthma occurs in response to a
trigger in the workplace. These triggers
include contaminants and allergens in the air
and extremes of temperature or humidity
What are factors that can
cause an attack?
In sensitive individuals, asthma symptoms can be triggered by inhaled
allergens such as:
Pet dander
Dust mites
Cockroach
Molds
Pollen.
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Asthma symptoms can also be triggered by:
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Respiratory infection
Exercise
Cold air
Tobacco smoke
Pollution
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Stress
Food
Drug allergies
Aspirin
Non-steroidal inflammatory
Medicines can provoke an asthma attack in some patients.
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Asthma affects 17.3
million people in the
United States. Asthma is
found in 3-5% of adults
and 7-10% of children.
Half the people with
asthma develop it before
age 10, and most
develop it before age
30. Asthma symptoms
can decrease over time
especially in children.
Who gets asthma?
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More than twice as
many boys than girls,
although boys are
more likely to
experience a
decrease in
symptoms as they
reach adolescence.
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In adult onset
asthma, however,
twice as many
women than men
visit the ER and are
admitted with asthma
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Asthma affects all
races worldwide, but
it is more common in
blacks and Hispanics
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Occupational asthma
is most common in
those who work with
animals or animalderived products and
in industries such as
plastics, rubber,
chemical, textile,
electronics, painting
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Printing,
metalworking,
baking and
gardening
Risk Factors for Asthma
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Smoking or living
with a smoker is a
major risk factor
About 25% of
children who have
asthma have at least
one parent who
smokes
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A family history of
asthma. If one parent
has asthma a person
has a 25% chance of
developing it. If
both parents have
asthma, a person has
a 50% chance of
manifesting it.
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Having allergies,
including any
hayfever and
eczema. It is not
known why some
people have alleriges
and some don’t, but
allergies can be
inherited
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Having allergies or
severe viral
infections before the
age of three
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Living in the inner
city or in a low
income group
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Being exposed to
mice and cockroach
waste products
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Frequently being
exposed to triggers
What are the symptoms of asthma?
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Wheezing, usually begins suddenly, is
episodic, may be worse at night or in
the early morning
Aggravated by exposure to cold air
Aggravated by exercise
Aggravated by heartburn
Resolves spontaneously
Relieved by bronchodilators (drugs
that open the airways)
Cough with or without sputum
production
Shortness of breath
Breathing that requires increased
work
Intercostals retractions (Pulling of the
skin between the ribs when breathing)
Additional Symptoms
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Nasal flaring
Chest pain
tightness in chest
abnormal breathing
pattern, breathing out
takes twice as long as
breathing in.
Asthma Symptoms
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What to look for if a child is
having difficulty breathing?
Respiratory Rate >40
worrisome
Are they having nasal
flaring?
Do you see neck muscles
sinking in?
Are they pulling in their
ribs?
What can be done to help
control asthma?
If you cannot cure it there
are steps to control it.
Tools used to detect asthma
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One way is through peak
flow meters.
With this meter you can see
when you are breathing
well, which is you personal
best, and when you are not
at your personal best , steps
you can take to prevent an
attack.
These readings are
categorized into zones.
Flow meter reading
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Green Zone – 80% of
personal best denotes good
control
Yellow zone- 50 – 80% of
personal best, caution need
to use an inhaler
Red Zone - <50% of
personal best denotes severe
asthma exacerbation, need to
use medicines, call MD, or
go to ER.
Prevention
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Avoid known allergens,
exposure to cigarette
smoke, air pollution , dust,
remove carpet from
bedrooms, vacuum
regularly. Remove pets
from patients bedroom.
May need to be allergy
tested.
Prevention
There are two basic kinds of
medications for controlling asthma:
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1.
2.
Long term control medications –
used on a regular basis to prevent
attacks, not for treatment during an
attack
Inhaled steroids – examples are
Azmacort, Vanceril, Aerobid ,
Flovent prevent inflammation.
Quick relief or rescue medications
– used to relieve symptoms during
an attack short acting
bronchodilators such as Proventil
Ventolin, xopenex, and others
Prevention
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Patients with mild asthma may
use relief medication as needed.
Those with persistent asthma
should take control medications
on a regular basis to prevent an
attack from occurring. A severe
asthma attack requires a medical
eval., and may require
hospitalization, oxygen and
intravenous medication.
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In conclusion, education needs to be
tailored to meet the patient’s individual
and family needs. Need to know factors
responsible for an attack.
Environmental control of allergies.
Medication use, when to take. How
often? Home peak flow monitoring.
What to do if symptoms worsen? What
medications to add or increase?
Develop a written action plan with
child and family to cover these issues.
Have proper supply of medications at
home, school, or setting where child
attends.
Goal of therapy is to maintain normal
activity.