Asthma

Admission Information and Discharge Instructions

Asthma Medicine Action Plan

What is asthma?

Asthma is a chronic (ongoing) lung disease in which the lining of the airways of the lungs is swollen or inflamed. The airways are unusually sensitive to certain irritants or "triggers." A trigger can be an irritant such as a cold virus, tobacco smoke, or cold air. An asthma trigger can also be something your child is allergic to such as pollen, animal dander, or house dust. When the airways react to a trigger, the muscles around the airways tighten and the lining of the airways swells and produces a thick mucus. This causes the airway to become narrow and makes it harder to breathe. This breathing difficulty is called an asthma attack. An asthma attack can be mild, moderate, or severe. When your child is having an attack, medicine will help reduce the symptoms.

When a child has asthma, symptoms usually come and go whenever they are triggered. Because asthma symptoms may return, your child needs to have a treatment plan and close follow-up by a healthcare provider.

What are the symptoms?

Symptoms of asthma may come and go and may include:

  • wheezing (a high-pitched whistling or musical sound while breathing out)
  • coughing, usually with lots of mucus
  • chest tightness
  • trouble breathing
  • trouble breathing or coughing during or after exercise.

Other severe symptoms in children are:

  • blue or gray lips or fingernails (Call 911)
  • flared nostrils when trying to breathe in
  • struggling to breathe
  • sucked in skin or muscles between the ribs or in the neck when breathing in
  • trouble talking, walking or playing

Why was my child admitted to the hospital?

Main complication:___________________________________________

___ Needs frequent or continuous medication to ease breathing

___ Needs oxygen

___ Needs IV fluids

___ Other reason: ____________________________________________

How long does it last?

Some children may have asthma symptoms for a few years and then grow out of it. Asthma symptoms often improve during the teenage years. For most children, however, asthma remains active all their lives. Asthma attacks may be frightening, but they are treatable. When medicines are taken as directed, the symptoms completely clear up.

What are the requirements for discharge?

  • _______________________________________________________
  • _______________________________________________________
  • _______________________________________________________

What type of medicine does my child need?

Quick-relief (rescue) medicine

Quick-relief medicines quickly open your child's airways and are used when your child is having an asthma attack. These medicines are called bronchodilators.

If your child is having asthma symptoms, he should take his quick-relief medicine. If you have any doubt about whether or not your child is wheezing, have your child start taking his asthma medicine. The longer he waits to take his medicine, the longer it takes to stop the wheezing. Once treatment with the medicine is begun, keep giving your child the quick-relief medicine according to the dose prescribed by your healthcare provider.

Your child's rescue medicine is __________________. Give _____ puffs every ____ hours. Continue the medicine until your child's wheezing is gone for ___ hours.

Controller (maintenance) medicines

Controller medicines help keep the airways in your child's lungs from becoming inflamed and irritated and help prevent asthma attacks.

Your child's controller medicine is __________________. Give _____ puffs every ____ hours. Controller medicines must be taken every day to prevent asthma attacks.

Children with the following symptoms usually need to take controller medicines every day to allow them to participate in normal activities:

  • 2 or more attacks of wheezing per week
  • 2 or more nighttime attacks a month
  • asthma flareups lasting several days
  • 3 or more visits per year for urgent medical care despite proper use of inhaler
  • asthma triggered by pollens (may need to use daily asthma medicines during the entire pollen season).

Peak Flow Meter.

A peak flow meter is a small hand-held device that measures the fastest speed air can be blown out of the lungs. Peak flow readings tell you if your child's asthma is in good control, if your child needs to take medicine, or if you need to get help right away. Measuring the peak flow regularly can help detect an asthma attack before it happens.

Other medicines

For pain or fever over 102°F (39°C) give ______________________________

_______________________________________________________________

_______________________________________________________________

Additional instructions

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

How can asthma attacks be prevented?

  • Try to discover and avoid the substances that trigger your child's asthma attacks. Second-hand tobacco smoke is a common trigger. If someone in your household smokes, your child will have more asthma attacks, take more medication, and need more emergency room visits.
  • Try to keep pets outside or at least out of your child's bedroom.
  • Learn how to dust-proof your child's bedroom. Change the filters on your hot-air heating system or air conditioner at least monthly.
  • For allergies to molds or carpet dust mites, try to keep the house humidity below 50%. Consider using a dehumidifier if necessary.
  • If your child wheezes after any contact with grass, weeds, or animals, there may be pollen or animal dander remaining in your child's hair or on his clothes. Your child should shower, wash his hair, and put on clean clothes.
  • For hay fever symptoms, it's OK to give antihistamines.
  • Give your child his quick-relief asthma medicine at the first sign of any coughing or wheezing. Watch your child carefully when he has a cough or cold and call your healthcare provider for advice if he is not improving after taking asthma medicine or if the symptoms are getting worse.
  • Your child can usually avoid attacks of coughing and wheezing by using a quick-relief medicine 15 to 30 minutes before exercise. If your child still has frequent symptoms with exercise even after using a quick relief medicine, talk with his healthcare provider.
  • Arrange to have the asthma medicines, a peak flow meter, and an Asthma Action Plan at school. If your child can't go to school because of asthma, take him to your healthcare provider that same day for advice about additional treatment.

When should my child be seen again?

___ Your child needs to be rechecked and has an appointment on _____________ at _______ with _________________________.

___ Your child needs to be rechecked in ________ days. Call your child's doctor to make an appointment.

___ A follow-up appointment is not necessary. Call the doctor if you have any concerns.

When should I call my child's healthcare provider?

Call IMMEDIATELY if your child:

  • has severe wheezing
  • has trouble breathing
  • has wheezing that has not improved after the second dose of asthma medicine
  • the peak flow rate is less than 50% of the personal best.

Call within 24 hours if:

  • The wheezing is not completely gone after 5 days.
  • Your child needs to use the quick-relief inhaler every 4 hours for more than 1 day
  • You have other questions or concerns.
Written by B.D. Schmitt, MD, and Robert Brayden, MD.
Published by RelayHealth.
Last modified: 2009-08-13
Last reviewed: 2009-07-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2009 RelayHealth and/or its affiliates. All Rights Reserved.