Paediatric Respiratory Nurse Specialists Aims of session What is asthma Triggers Signs and symptoms Treatments including spacer technique Recognising poor control Managing asthma ID: 635999
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Asthma
Catherine Crocker & Tricia McGinnity
Paediatric Respiratory Nurse Specialist’sSlide2
Aims of session.
What is asthma. Triggers.
Signs and symptoms.Treatments including spacer technique.Recognising poor control. Managing asthma. Slide3
WHO - Definition of asthmaThis condition is due to inflammation of the air
passages in the lungs and affects the sensitivity of thenerve endings in the airways so they become easily irritated. In an attack, the lining of the passages swell causing the airways to narrow and reduce the flow of airin and out of the lungs.
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Asthma - changes in airwaysSlide5
About AsthmaIt is common. Estimated that 5.4 million people in the UK have asthma, 1.1 million of those are children(Asthma UK). 1 in 11 children, therefore 2-3 children in every classroom
It can be disruptive – sleep disturbance, poor concentration, stops participation in activities, growth & developmentSlide6
About AsthmaIt is long term. Variable condition that can be worse at certain times
It is serious. Approximately 1,200 people in the UK die from asthma each year, 20-40 of these will be childrenIt is estimated that 90% of deaths may be preventable. Slide7
TriggersAllergic TriggersDust
AnimalsPollenMouldsFoodLatexNon-allergic Triggers
InfectionsSmokeExercisePollution/fumesStress/emotionHormonesSlide8
Signs and symptoms Coughing.
Shortness of breath. Wheezing. Tightness in the chest. Difficulty speaking in full sentences.
Asthma varies in severity from child to child. Some children will experience an occasional cough or wheeze but others will havesevere symptoms.Slide9
Treatments
QuestionsResponses
The “Transition: moving into adult care ” helped patients +family understand why they are starting RSGAll agree
The questionnaires were easy to understandAll strongly agree/agreeRSG questionnaires helped focus clinic appt + address difficult issues
All agree
(1/62
disagreed)
RSG helps ease the process of transition
All strongly agree/agree
Any
questions that would help improve transition?
All –
No
Time issues
Relevance of some questions especially in patients with learning disabilities
Reliever inhalers:
Usually blue e.g.;
Salbutamol
Should be taken with symptoms. Essential treatment for treating exacerbations.
Work by relaxing the muscles surrounding the narrowed airways. They do not reduce the inflammation.
Preventer inhalers
:
Usually brown or orange e.g.;
Beclomethasone
/
Fluticasone
Protect the lining of the airway, reduces the inflammation. Airways are less likely to react when they come into contact with a trigger.
Protective effect builds up over time, therefore need to be taken everyday.Slide10
Spacer technique.
All children using a metered dose inhaler (MDI) should use a spacer.Check that the spacer is clean and not damaged
Remove the inhaler cap, shake the inhaler and put it into the back of the spacer. Place the mouthpiece of the spacer in the mouth (or place mask securely over nose & mouth)Press the inhaler once to release a dose of the medicineBreathe in and out five times making the valve click each timeRemove the spacer from the mouthWait about 15 to 30 seconds before giving the next dose.Slide11
Managing asthma in schools & nurseries
Pupils should have easy access to their reliever inhaler at all times. It should not be kept in a locked room or locked drawer.Every child should have an asthma action plan which should include details of medications, symptoms and what to do if child has an asthma attack.
It should be simple & easy to accessBelieve the child & reassure.Slide12
What to do in an asthma attack
Stay calm.
Sit the child upright
Help them take their inhaler 2 – 4 puffs
After 5 minutes have symptoms improved?
Yes.
No.
Inform parents
If well could go back to class.
A responsible adult should observe the child and act if condition returns or worsens.
Give a further 6 – 8 puffs.
Call 999.
Call parents.
While waiting for ambulance further doses can be given.Slide13
Red flagsToo breathless to talk
Blue lips (cyanosis)Loss of consciousness or altered consciousnessAgitationComplaining of a tight chestSlide14
ResourcesAsthma UK
– Literature. Information packs for children, young people and adults to read.George Coller Memorial Fund & Education For Health collaboration created free educational resource. Asthma module for non healthcare professionals working with children. http://www.supportingchildrenshealth.org.
https://www.monkeywellbeing.com/ Resources for schools & younger children ‘Monkey has asthma’.
Parents.
School nurse.
GP.
Practice nurse.
Sally Griffin –
Children’s Community Asthma Nurse (Southampton City).
Paediatric Respiratory Nursing Team –
Southampton Children’s Hospital.Slide15
Asthma controlUncontrolled – daily symptoms, disturbed sleep, using reliever daily or more often.
Poorly controlled – day symptoms > 3 times a week, waking at night with symptoms >1 night a week. Using reliever > 3 times a week. Limitation on activities No / minimal symptoms, no asthma attacks, no use of reliever, no sleep disturbance, active!