Childcare｜CHCECE002 # 7 - Asthma
學習筆記 Childcare
CHCECE002
Ensure the health and safety of children
#7 - Asthma
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| 來源：いらすとや |
# What is Asthma?
．a condition changes all the time
．airways (breathing tubes) are more sensitive than normal
．airways overreact and become narrow and inflamed when exposed to triggers
> hard to breathe
> muscles of airways tightened
> redness and swelling (inflammation) in the lining of airways
> extra mucous (secretions)
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．called： episode of asthma / asthma attack
# Signs and symptoms
．wheezing (high pitched raspy sound / whistle when breathing out)
．shortness of breath
．difficulty breathing
．tightness in chest (sore tummy / feel sore or hurting)
．coughing (at night / early in the morning / associated with exercise)
** symptoms vary from child to child & from time to time
** do not need to have all the symptoms present at any one time
** cough without signs and symptoms of asthma may due to other lung problems
** wheezing is common in young children but not all wheezing is asthma
．warning signs of worsening asthma
> recurrent night time coughing / wheezing
> early morning coughing / wheezing
> unable to participate in usual activities without wheezing, coughing or becoming short of breath
> miss out school due to asthma symptoms
> use reliever medicine on more than 2 days per week
> use reliever medicine every 3 - 4 hours
# What causes asthma?
．X fully understood
．can present at any age
．exposure to cigarette smoke during pregnancy and early childhood ↑ risk of asthma
．presence of confirmed allergies
．family history of asthma / allergies
# What is a trigger factor?
．tigger factor = substance / change in environment that brings on asthma attack
．most common： cold / respiratory (chest) infection caused by virus
．e.g.
。smoke (cigarette / fire)
> stop smoking
> X smoke in car even the child not with u
> avoid take the child to places where people are smoking
。inhaled allergens (animals, dust, pollen, moulds)
> wipe the areas, wash bed linings regularly
> vacuuming
> groom pets regularly
> avoid windy, high pollen-count days
。foods and additives
> maintain healthy diet
。exercise (exercise-induced asthma, EIA)
> begin and finish with warm-up and cool-down exercises
> take blue relever medicine before exercise
> avoid exercising under bad air condition
。air environment (changes in temperature, humidity, windy conditions, season, weather)
> be aware of weather forecast
> monitor through Air Quality Index (AQI)
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| Air Quality Index (AQI) Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
。emotions (anxiety, stress, distress, laughing)
> provide reassurance and find ways to teach relaxing
。medications (non-steroidal anti-inflammatory drugs)
。homeopathic / herbal remedies (Echinacea, Royal Jelly, Willow Tree bark extracts)
．may be different for each person
．may be more than 1 trigger
# Different degrees of asthma
．may be mild, moderate, severe, episodic, persistent
> depend on frequency of symptoms
severity of the asthma attacks
amount of medication required
** any degree of asthma can experience severe life-threatening attacks
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．call ambulance when
> use reliever more frequently than every 2 hours
> distressed & anxious
> sucking in at the throat and ribs when breath
> bluish tinge to the lips
> unable to talk due to breathlessness
> if concerns / doubts
# Does medication help?
．Yes, best way to control = medications
．well-managed asthma = a full, active life
> X have daytime asthma symptoms > 2 days per week
> symptoms quickly relieved by asthma reliever medicine
> X have asthma symptoms during the night / upon wakening
> able to participate in usual activites with X asthma symptoms
．usually taken by breathing (goes straight into the lungs)
．always have a spare reliever medicine
．how to clean：
- rinse plastic holder with warm running water
- shake out excess water and dry
- X wash canister
．4 types of medication：
1. Relievers
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
> blue / grey coloured devices
> e.g. Ventolin, Asmol, Epaq, Airomir, Bricanyl
> relieves symptoms of asthma (open narrowed airways, relax tight muscles)
> use in asthma first aid
> works very quickly (in ~ 4 mins) & last up to 4 hrs
> use when u has symptoms / in emergency / before exercise
> use too often = poor control → may need regular preventer medicine
> X take on > 2 days per week
> possible side effects： fast heart rate, shaky hands, hyperactivity, excitability
2. Preventers (anti-inflammatories)
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
> autumn-coloured devices
> steroid-based, e.g. Pulmicort, Qvar, Flixotide, Alvesco
> non-steroidal, e.g. Montelukast, Singulair, Intal, Forte
> treat inflammation in airways (↓ swelling and mucus)
> make the airways less sensitive to trigger factors
> may be inhaled / in tablet form
> must be taken every day (even feels well)
> X work straight away, but will start to feel better in a few weeks
3. Combination medications
> purple and red / white-coloured devices
> e.g. Seretide, Symbicort
> combine steroid based preventer and long-acting reliever
4. Rescue medicine (Oral Corticosteroids)
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
> e.g. Prednisone (tablet), Prednisolone (tablet / syrup), Predmix and Redipred (syrup)
> use for short periods (3 - 5 days) during asthma flare-up when there is little or no response to inhaled reliever medicine
> ↓ airway inflammation
# Instrustions on How to use Medication
AEROSOLS
．How to use A Metered Dose Inhaler (puffer)
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．How to use Autohaler
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
DRY POWDER DEVICES
．How to use Turbuhaler
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．How to use Accuhaler
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．How to use Ellipta
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| How to use Ellipta Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
# Spacers
．plastic cylinder-shaped devices
．attach to puffer at one end, other end goes in mouth
．↓ amount of medicine lands in mouth, ↑ amount go down into lungs
．fewer side effects from the medication
．easier to use than puffer alone
．must clean (wash with warm soapy water, air dry, X rinse) before 1st use
．use a cloth to dry → cause static electricity → medication cling inside spacer
(some spacers are made from anti-static materials)
．clean spacer every month
．small volume spacer with a mask (child < 4 years)
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．small / large volume spacer without a mask (child > 4 years)
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| Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．video demonstrations： How to use a Puffer and Spacer for Kids
# Asthma action plan
．designed to tell you and yr child how to prevent and manage asthma attacks
．have it up to date
．ask the Dr to explain how to use the plan
．follow it when asthma attacks occur
．keep in safe place where can easily find
．share with anyone who will care for the child
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| Source: National Asthma Council |
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| Source: Asthma Australia |
．more to read： Asthma action plan library
# Achieving and Maintaining Good Asthma Control for your Child
．visit doctor regularly → every 3 - 6 months
> take the device(s) and asthma action plan every visit
> keep an asthma symptom diary
> assess and monitor the level of asthma control
> discuss concerns about asthma management
．ask doctor for asthma action plan
> detailed plan designed for the child
> provide information about the type of medicine the child is prescribed, how much to give, how often
> minimun review every 6 months
．be aware of asthma triggers
> understand what triggers → minimise exposure, monitor situation
> keep a record of any asthma symptoms and potential triggers
> inform other carers of the triggers
．record asthma symptoms
> type of symptoms, when they occur, whether symptoms disturb sleep or interfere with usual activities, how often reliever medicine was needed to control symptoms
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| Example of a Symptom Diary Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
．check medicine delivery device technique is correct
> correct = best chance of receiving full dose of medicine
# Asthma First Aid
In the event of severe symptoms, i.e. great difficulty in breathing; sucking in at the throat or chest; distressed, anxious, drowsy,
confused, exhausted; lips have a bluish tinge; only able to speak in words or unable to speak at all, call an ambulance.
Dial 000 and commence asthma first aid as per the below steps.
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| Asthma First Aid Source: Asthma and Your Child - A Resource Pack for Parents and Carers |
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| Source: Asthma Australia |
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| Source: National Asthma Council |
** if a child with known anaphylaxis to other substances has sudden breathing difficulty
→ give adrenaline autoinjector first
→ then blue / grey puffer
# Things to remember
．make sure u / yr child knows how to take medication
．make sure the medication with the child at all times, with name, dose, X expired
．make sure the caring person knows the child has asthma & what to do
．have Asthma Action Plan
．visit doctor every 3 - 6 months
Resource:
2. Asthma and Your Child - A Resource Pack for Parents and Carers
3. National Asthma Council Australia
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