Five Tips For Improved Asthma Management

STANFORD -- Hearing that your child has asthma can be overwhelming. But if it's correctly managed, most kids with asthma can live healthy lives full of running, sports and play. Check out these five tips for better asthma management.

1. Know your child's triggers

Triggers are the specific things that cause asthma flare ups or events. Identifying your child's triggers can help you prevent asthma events or recognize them quickly. Common triggers include infection; exercise (especially if asthma is not well controlled); smoke of any type; perfumes; scented lotions, soaps, makeup, and cleaning products; and allergens. Indoor allergens can include furry pets, dust mites and cockroaches, and outdoor allergens can include mold and pollen.

2. Develop a written action plan

It is scary for you and your child when he or she can't breathe. Children may not always follow predictable patterns, and sometimes a severe asthma event can happen with little warning. A written action plan can take the guess work out of what to do when this happens. It is most helpful to use a traffic light pattern:

(A) Green for when there are no symptoms

(B) Yellow for the onset of colds, for cough and wheezing, or when known triggers are present

(C) Red for when medications are not working well or your child has increased trouble breathing. This could include coughing, wheezing, retractions (when the skin sucks against the bones of the chest and neck), nasal flaring, faster breathing and increased effort to breathe.

As asthma worsens, kids can have trouble walking and talking. Call 911 immediately if your child is in severe distress or his or her skin color becomes dusky or blue.

The action plan will detail which medications and doses you should take at each color stage.

3. Learn the details of proper device use

Many devices can deliver medications to the lung. It is critically important to know how to use your device correctly. Metered dose inhalers (MDI) are commonly used, and they must always be used with a holding chamber or spacer. Babies and young children use a face mask that fits over the nose and mouth, while older children who know how to breath and hold their breath can use a mouthpiece.

Teaching this breathe-and-hold skill is very important, and making it a fun game helps. Dry powder inhalers (DPI) require different skills. Be sure to have your provider teach you how to correctly use the device in a hands-on session with the actual device you will have at home.

Always bring your devices to every visit to show the team how you are using them. Kids' skills often slip and need correcting over time.

4. Identify empty inhalers

Make sure your provider orders an inhaler with a counter so you know exactly how many puffs are left in the device. Decide how much time you need to get a refill, and make sure to build in enough time so that you never run out of medicine. Remember that each inhaler will need to be primed before use if it has not been used for weeks. To prime an inhaler, puff it into the air a few times before using the medication on your child.

5. Communicate effectively with your provider

You, your child and your provider form a team. It is vitally important that you talk regularly. Don't be afraid to ask your provider all the questions you have. If your provider suggests changes in the home environment, make them promptly.

Community resources may be available to help you make these changes — ask your provider. For example, home visits are provided by some insurance companies and local resources. These visits can help you spot improvements that may keep your child healthier.

More tips

Learn how to use two common types of inhalers with video tutorials available at asthma.stanfordchildrens.org.

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