We CANControl Asthma

Now

“Not affiliated with the YES WE CAN Asthma Program of San Francisco State University/ City College of San Francisco.”

Asthma: The Reality

• Over 17 million in the United States, with 5 million youth

• 2.3 million in California, with a projected 10% prevalence rate in Long Beach

• Asthma prevalence and mortality (death) rates have been increasing, especially 5-14 years old

• Affects populations of all ages and SES• Low income and minority populations have the

highest asthma morbidity (burden of disease)

The Long Beach Alliance for Children With Asthma

• Vision: The Long Beach Alliance for Children with Asthma is a partnership to improve the lives of children with asthma in our community

• One of 7 sites awarded grants under the RWJ Foundation’s Allies Against Asthma program and one of 12 sites awarded grants under CA Endowment’s Community Action to Fight Asthma (CAFA) program

• Focus is on 90813 and Long Beach as a whole

What is Asthma?

• A chronic (long-term) disorder of the airways, in which the airways become blocked or narrowed

• A condition that causes breathing problems, called attacks or episodes

• Its direct cause is unknown-genetics vs. environment?

• It can be life threatening

Pathology of Asthma

• Airways are the passages that carry air to the lungs. They become smaller and smaller, like branches of a tree.

• Asymptomatic vs. Symptomatic

What isHappening…

Swelling (inflam m ation),which m akes the a irways sm allerand harder for a ir to go through.

Tightening (constriction)of the m uscles around the

airways, m ak ing them sm aller.

Too m uch m ucusis m ade, trapping the a ir.

Asthm a Episode

Signs and Symptoms

Coughing- day, night, or with exercise Trouble Breathing Wheezing (whistling noise) Tightness in Chest Trouble Sleeping/ Waking at night Drop in Peak Flow Meter Irritability

Triggers Smoke & Strong Odors Pets Mold Dust, Dust mites Pollen (grass, trees, plants, & weeds) Pests (cockroaches or rodents) Certain Foods Infections (flu and colds) Exercise Changes in Weather Strong Emotions Pollution Some medications (aspirin)

Trigger Pictures

Medications

Quick Relief (bronchodilator)

o Open the airways fast to stop an Asthma attack

o Short acting- up to 4 hours

o Some use before exercise or exposure to trigger

o Albuterol

Long-Term-Control(anti-inflammatory)o Decreases swelling and

mucus productiono Must be taken daily,

long-actingo Flovent, Azmacort,

Pulmicort, Vanceril, Advair, Serevent, Singulair, and Intal

o May take up to 2 weeks to work

Asthma Devices

InhalerSpacer, with and without a maskNebulizerDiskusPeak Flow MeterAsthma DiaryAsthma Action Plan

Signs of an Asthma Emergency in Children

Persistent or worsening asthma signs or symptomsExtreme difficulty breathing and talkinguncontrolled coughsevere chest tightnesscan’t talk, walk or move welllips or fingernails turn blue

ACT NOW!!!

What to do in an Asthma Emergency

Do not leave the child aloneCalm the childSeat child uprightAdminister the Quick Relief or Rescue

Medication (Albuterol) immediately and follow the child’s Asthma Action Plan

If asthma signs do not improve immediately call 911 or go to the nearest emergency room

Working with your child’s asthma team

• Ask your doctor about any information that you are unsure of

• Take all medications as prescribed• Follow your asthma action plan• Go to all scheduled appointments and take medication

and equipment• Notify anyone who spends time with your child that she

or he has asthma and what to do in an asthma emergency (babysitters, coaches, school nurse, camp counselors, and teachers)

Asthma Affected by Exercise

• Exercise Induced Asthma (EIA) = experiencing trouble breathing during or after exercise or some kind of physical activity

• EIA is the most common form of asthma and can be controlled

• Warm up for 10-15 minutes, to increase your heart beat gradually

• Avoid exercising during cold or dry weather • Finish with cool down exercise

Asthma Affected by Exercise

• Remember to take medicine at least 15 minutes before exercising

• Choose a sport/activity that fits within your Asthma management (e.g. swimming, biking, football)

• Avoid exercising on polluted or on smoggy days• Coaches and P.E. teachers should be notified of

child’s asthma and what to do in an emergency

We C.A.N. Control Asthma Now“Training of Trainer”

Health Education Materials

Sponsored by:

The Long Beach A lliance for Children WithA sthma

A nd

The Children’s ClinicServing Children and Families

We CANControl Asthma

Now !

Asthma 101Not affiliated with the YES WE CAN Asthma Program of San Francisco State University/ City College of San Francisco.”

The Long Beach Alliance for Children With Asthma

W H A T T O D O I N A N A S T H M A E M E R G E N C Y I N C H I L D R E N

P E R S I S T E N T O R W O R S E N I N G A S T H M A S I G N S O R S Y M P T O M S

12

3

S I G N S O F A N A S T H M AE M E R G E N C Y

D O N O T L E A V E T H E C H I L D A L O N E C A L M T H E C H I L D S E A T C H I L D U P R I G H T

A D M I N I S T E R Q U I C K - R E L I E FM E D I C I N E ( A L B U T E R O L )I M M E D I A T E L Y

F O L L O W T H E C H I L D ’ S A S T H M AA C T I O N P L A N

I F A S T H M A S I G N S D O N O TI M P R O V E I M M E D I A T E L YC A L L 9 1 1 O R G O T O T H E N E A R E S TE M E R G E N C Y R O O M

C r e a t e d b y t h e L o n g B e a c h A l l i a n c e f o r C h i l d r e n w i t h A s t h m aF o r m o r e i n f o r m a t i o n ( 5 6 2 ) 4 2 7 - 4 2 4 9

E X T R E M E D I F F I C U L T YB R E A T H I N G A N D T A L K I N G D U E T OS H O R T N E S S O F B R E A T H

U N C O N T R O L L E D C O U G H

S E V E R E C H E S TT I G H T N E S S

C A N ’ T T A L K , W A L K , O RM O V E W E L L

L I P S O R F I N G E R N A I L ST U R N B L U E

C r e a t e d b y t h e L o n g B e a c h A l l i a n c e f o r C h i ld r e n w i t h A s t h m a a n d T h e C h i l d r e n ’ s C l i n i cF o r m o r e i n f o r m a t io n ( 5 6 2 ) 4 2 7 - 4 2 4 9

D evelo ped by: A STH M A A CT IO N A M ER IC A ( www.A sthm aA ctio n A m erica.o rg) F o r M o re in fo rm atio n call:L o n g B e a c h A llia n c e f o r C h i ld r en w it h A st h m a562-427-4249

I s yo u r asthm a “co n tro lled”?Take the 30 Seco n d A sthm a Control Test

1. In the past 4 weeks, ho w m uch o f the t im e did yo u r asthm a keep yo u fro m gett in g as m uchdo ne at wo rk o r at ho m e?

N o n e o f the tim e A litt le o f the t im e

So m e o f the t im e m o st o f the t im e all o f the t im e

2 . D urin g the past 4 weeks, ho w o ften have yo u had sho rtness o f breath? N o t at all O nce o r twice a week

3 to 6 tim es a week o n ce a day m o re than o nce a day

3. D urin g the past 4 weeks, ho w o ften did yo u r asthm a sym pto m s ( wheezing, co ughin g, sho rtnesso f breath, chest t ightn ess o r pain ) wake yo u up at n ight o r earlier than usu al in the m o rn ing?

N o t at all O nce o r twice

O nce a week 2 to 3 n ights a week 4 o r m o re n ights a week

4 . D urin g the past 4 weeks, ho w o ften have yo u u sed yo u r rescu e inhaler o r n ebu lizer m edicat io n( such as albutero l) ?

N o t at all O nce a week o r less

A few t im es a week 1 o r 2 t im es per day 3 o r m o re t im es per day

5. H o w wo u ld yo u rate yo u r asthm a co n tro l du ring the past 4 weeks? C o m pletely co n tro lled W ell co n tro lled

So m ewhat co n tro lled P o o rly co n tro lled N o t co n tro lled at all

I f yo u checked an y blu e an swers, yo ur asthm a m ay n o t be wellco n tro lled. Be su re to talk to yo u r healthcare pro fessio n al abo u tyo u r asthm a treatm en t plan .

Developed by: ASTHMA ACTION AMERICA

Tips for Watching Students at Play ……looking for asthma

1. Watch for Childeren: Unable to keep up with the others. Stopping frequently to breathe. Frequent coughing. Working hard at breathing (chest is heaving). Dusky color (gray-blue), especially around the lips and fingernails. Can’t walk or talk or play because working too hard to breathe. Gasping for breath. Says he/she can’t breathe or has chest pain or tightness. Staggering Wheezing (whistling sound when breathes).

2. What to do…. A sk student if he/she has asthma and is having trouble breathing. If yes, ask student if he/she needs to take a break and use his or her

inhaler (medicine for asthma). Escort student to health offi ce if student is able to walk. If student is unable to walk, send another student or supervisor to health

offi ce for help. Tell student to ask someone for the child’s inhalermedicine.

Do not leave child alone. A sk health staff for a list of students with asthma.

3. Call 911 or go to the nearest emergency room if A sthma signs do not improve immediately after quick relief medicine or if the child is unresponsive.

Developed by fight A sthma M ilwaukee

Long Beach A lliance for Children with A sthma2651 Elm A ve. Suite 100Long Beach, CA 90806

(562) 427-4249

Developed by Fight Asthma Milwaukee

W hat is ExerciseI nduced Asthma

(EI A)???

Ex per iencing t r oublebr eat hing dur ing or af t er ex er cise or some kind ofphysical act ivit y

T he air ways of t he lungs get smaller because t hemuscles t ight en ar ound t he air ways and a lar ge amountof mucus is pr oduced

E I A is t he most common f or m of A st hma and can be cont r olled by r egular and

nor mal means of ex er cising!

T ake quick r elief medicat ion (A lbut er ol,Vent olin orS er event ) apr escr ibed by your doct or —at least 15minut es bef or e exer cising

W ar m up f or 10-15 minut es, t o incr ease your hear tbeat gr adually

Asthma Jeopardy could be played in team of two or more. The questions are separatedinto asthma categories and range from $100-$400. Write the asthma categories and price

ranges on the board and keep the questions and answers.

Asthma Facts Triggers Solutions to Triggers

$100A condition in the lungs that

makes breathing difficult

$100Cigarette smokes, Perfumes,nail polish are examples of

what kind of trigger.

$100Storing food in these could

keep cockroaches fromcoming around

$200Two common asthma triggers.

$200Things that may bother theairways, making it hard tobreathe or cause Asthma

signs.

$200Washing stuffed animals inwater hotter than 130 F kills

these triggers.

$300Two types of asthma medicine

$300Small microscopic animals

that live in mattresses, teddybears, on our skin, anywhere

there’s dust

$300Mixing water and what

solution is effective in killingmold spores

$400Three things that occur to the

airways during an asthmaattack?

$400These pests have been inexistence since before the

dinosaurs and their bodies andspray are what cause an

allergic reaction

$400If you have exercise inducedasthma how long before you

exercise should you take yourmedicine

$500The number of children in the

United States affected byasthma

$500This allergen grows best inhumid and dark locations.

$500One of most recommendedand preferred methods of

getting rid of roaches$600

You should take this type ofmedicine everyday

$600These cuddly animals produce

allergens because of thedander that is found on there

furry coats

$600If a child with asthma liveswith a smoker, where is the

best place to smoke

U s e L o n g - T e r m - C o n t r o l M e d i c i n eE V E R Y D A Y t o k e e p A s t h m a i n c h e c k !M e d i c i n e H o w M u c h W h e n_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _E x e r c i s e I n d u c e d A s t h m a -2 0 m i n u t e s b e f o r e s p o r t s :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _

G R E E N = G O ! B r e a t h i n g i s g o o d N o c o u g h o r w h e e z e ( w h i s t l e

n o i s e ) C a n w o r k o r p l a y a s n o r m a l

O R P e a k F l o w N u m b e r i s : _ _ _ _ _ _ _ t o _ _ _ _ _ _ _ 8 0 % 1 0 0 %

Y E L L O W = SL O W D O W N

T ight Chest Cough W heezing O R Peak Flow Number is: _ _ _ _ _ _ _ to _ _ _ _ _ _ _ 60% 79%

M Y A S T H M A A C T I O N P L A N :C h i l d ’ s N a m e : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _D . O . B . : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ M D / N P ’ sS i g n a t u r e : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _D a t e C o m p l e t e d : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _I g iv e p e rm is s io n fo r th e s c h o o l n u r se o r d e s ig n a te d s c h o o l p e r so n n e l to a s s is t m y c h ild w ithth e A s th m a A c tio n P la n . I a lso g iv e p e rm is s io n fo r s c h o o l p e r so n n e l to e x c h a n g e in fo rm a tio nw ith th e p h y s ic ia n r e g a rd in g m y c h ild ’s a s th m a .G u a rd ia n ’s S ig n a tu re :_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _P e r s o n a l B e s t P e a k F l o w : _ _ _ _ _ _ _ _Y o u c a n u s e t h e c o l o r s o f t h e t r a f f i c l i g h t t o h e l p y o u l e a r n t o c o n t r o ly o u r A s t h m a !

T a k e Q u i c k -R e l i e f m e d i c i n e to s to py o u r A s th m a f r o m g e tt i n g w o r s e !1) Cont inue medicine in GREEN ZO N E2) Start A l b u t e r o l (i n h a l e r w i t h

s p a c e r / s p a c e r w i t h m a s k )r i g h t a w a y – 2 sprays, then every 4- 6hours as needed.

3) I f y o u a r e i n t h e Y e l l o w Z o n ea n d h a v e n o i m p r o v e m e n t i n6 - 1 2 h o u r s e v e n a f t e r u s i n gA l b u t e r o l – c a l l y o u r d o c t o r .

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

T a k e Q u i c k -R e l i e f M e d i c i n e a n d g e th e l p f r o m a d o c to r n o w !

1 ) S t a r t A l b u t e r o l r i g h t a w a y – 2 s p r a y s2 ) G o t o T h e C l i n i c - N u r s i n g S t a t i o n O R i f c l o s e d , g o to th e E m e r g e n c y R o o m /C a l l 9 1 13 ) M a k e a f o l l o w u p a p p o i n t m e n t a t t h e C lin ic fo r t h e fo llo w in g d a y if yo u w e n t to th e E R4 ) C o n t i n u e t a k i n g m e d i c i n e i n G R E E N Z O N E

R E D = ST O P M e d i c i n e i s n o t h e l p i n g C a n ’ t t a l k , w a l k o r m o v e w e l l H a v e e x t r e m e d i f f i c u l t y b r e a t h i n g S e v e r e c h e s t t i g h t n e s s U n c o n t r o l l e d c o u g h

O R P e a k F l o w N u m b e r i s : _ _ _ _ _ _ t o _ _ _ _ _ _ 0% 59%

Checklist for Asthma-Friendly School or After-School/Rec

ProgramsMedical Issues

ASK students and parents about their asthma and medication

Plan for responding to an asthma emergency

Plan for accessing medication - have appropriate medication, spacer, and plan available to child and personnel

Checklist for Asthma-Friendly School or After-School/Rec

ProgramsMedical Issues

Limit outdoor activity on poor air quality days

Watch children while playing for symptoms and early signs of an asthma attack

Watch use (and overuse) of inhalers

Checklist for Asthma-Friendly School or After-

School/Rec Programs

EnvironmentClean spills promptly (carpets need to be cleaned

properly and dried within 24 hours to prevent mold growth)

Keep room clean and clutter-freeKeep room dusted, vacuum thoroughly and

regularlyDo not use carpet mats or stuffed pillowsRemove trash daily

Checklist for Asthma-Friendly School or After-School/Rec

ProgramsEnvironment

Do not keep food in room overnight Keep setting free from furry or feathered animalsKeep room free from pests Keep room free of the use of scented cleanersNo perfumeLeast toxic pest management and landscaping

Checklist for Asthma-Friendly School or After-School/Rec

ProgramsEnvironmentLow allergen plants, trees and flowersKeep exposure to furry or feathered animals to a

minimum, clean cages regularly, consider outdoor pets, and consider children in the classroom with identified allergens

Do not locate animals near ventilation system vents

Do not block ventilation system vents

The Faces of Asthma