Acute Exacerbation of Asthma Management,Patient Education,Risk Factors

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

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ASTHMA IN CHILDREN

Dr C.T.Deshmukh
Professor of Pediatrics, K.E.M Hospital

Patient Education and Asthma

Patient Education :

Education of patient and active partnership of patient and doctor is the cornerstone of asthma management.

Starting patient and family education at the time of diagnosis, integrating it into every step of clinical asthma care, and tailoring it specifically to the needs of each patient, with sensitivity to cultural beliefs and practices.

Patient education covers

Basic asthma facts - Taught to understand their asthma; to know how to recognize symptom patterns indicating that their asthma is getting out of control. This can prevent emergency room visits and hospitalizations

Roles of medications - difference between quick relief and long term control

Skill needed for inhaler and spacer use and self monitoring with PEFR meter

Environmental control measures and avoidance measures.

When and how to take rescue steps, written treatment plans.

Management of acute exacerbation of asthma

Asthma exacerbations are acute episodes of progressive worsening of breathing, cough, wheeze and chest tightness. These exacerbations are characterized by decrease in PEFR whish in turn can be easily quantified by PEFR meter or spirometer. These objective measurements indicate severity more accurately than symptoms.

The aim in management of acute asthma is:

Correct significant hypoxemia - (O2, mechanical ventilation rarely needed)

Reverse airflow obstruction as rapidly as possible.

Reduce inflammation and risk of recurrence by intensifying therapy.

Early treatment is important to prevent hospitalization and/or the attack from becoming severe. The following points are important for the same:

Written instruction to patient for self treatment.

Early diagnosis of worsening by PEFR meter or spirometer.

Early contact with doctor regarding clinical or PEFR changes.

Early increase in therapy (β 2 agonist, oral steroids).

Remove precipitating factor if any.

Patients with high risk for asthma deaths need extra attention.

High risk factors for death in asthma:

Past history of severe exacerbations.

History of intubation mechanical ventilation for asthma.

More than two hospitalizations for asthma in past one year.

History admission to Pediatric intensive Care unit for asthma.

Use of oral steroids for current attack.

Excessive use of β agonist.

Frequent emergency visits for acute asthma.

Associated cardio-respiratory diseases.

Next : Asthma Management and Refrences

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