Healthy ChildrenHealthy Lungs

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Healthy Children-Healthy Lungs

• Asthma in Children in Child Care
• developed by
• June Cuddihy, RN,CS,MSN
• Catholic Charities,
• Unified Child Care Program

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When health is absent,wisdom cannot
reveal itself, art cannot become manifest,
strength cannot fight, wealth becomes useless,
and intelligence cannot be
applied. Herophilius of Chalcedon,335-280
BC Physician to Alexander the Great
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What Is Asthma

• An estimated Five Million children suffer from
  asthma
• Asthma is a chronic inflammatory disorder
  associated with airway hyperresponseness, airflow
  limitation,and respiratory symptoms
• Asthma is characterized by coughing, chest
  tightness and difficult breathing

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Early Warning Signals

• Every child has a built-in warning system
• These signals can be
• Seen
  
• Heard
• Felt
• Every child has their own patterns of signals

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Continued

• You can make observations a habit and be able to
  recognize patterns
• These patterns are messages to get going and head
  off increased symptoms

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What to Look For

• Anxious or scared look
• Cough
• Unusual paleness or sweating
• Flared nostrils
• Pursed lip breathing
• Fast breathing

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Continued

• Vomiting
• Hunched over posture
• Restless during sleep
• Fatigue
• Space between the ribs may sink in when the child
  breaths

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What to Listen For

• Coughing when the child has no cold
• Clearing the throat a lot
• Irregular breathing
• Wheezing
• Noisy, difficult breathing

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How to Listen

• Place your ear to the childs back and hand on
  the childs chest
• You will feel the chest go up and down with
  breathing
• Listen for squeaking or unusual noises. a signal
  that intervention may be necessary (wheezing)

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Signs of an Attack

• Itchy, watery, or glassy eyes
• Itch, sore throat
• Sneezing
• Congestion
• Restlessness
• Runny nose
• Dark circles under the eyes

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What to Do Immediately

• Reassure the child
• Institute the Asthma Action Plan
• Each child has different asthma symptoms
• Learn these symptoms and respond to the symptoms
  to prevent an severe episode
• Parents and physician need to be informed

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Additional Steps to Take

• Help the child by a calming manner
• Keep child and other children informed of what
  you are doing
• If you identify what triggered the symptoms,
  remove it or remove the child
• The Action Plan can help you decide what further
  measures to take

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Types of Asthma Medications

• Anti-allergy medications
• Anti-inflammatory medications
• Bronchodilators-rescue medications

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Responsibilities of Providers

• Learn the basics of asthma
• Consultant with the childs parents, physician
  and your health consultant
• Learn about the childs symptoms
• Learn about the treatment

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It Is Important to Find Out the Following

• How severe is the asthma
• How to judge the severity of an attack
• Is treatment needed
• Do you call 911
• What triggers attacks for each child

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Continued

• What medicines are to be given to the child
• What are the effects, side effects and actions of
  the medications
• How to use a nebulizer correctly

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Continued

• How to use an inhaler
• How to use a peak flow meter if age appropriate
• What to do in an emergency

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Collect and Record Information

• Have forms completed by physician, that give
  exact information called an Asthma Action Plan
• Record medication and use your observation skills
  to identify the childs symptoms

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Continued

• Share all information with the parents
• Develop a management plan and an action plan

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Continued

• Keep all information in the childs file for easy
  access
• Provide staff training on asthma
• Modify the environment as needed
• Become familiar with the early signs and symptoms
  to reduce the incidence of a severe episode of
  asthma

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When the Asthma Episode Occurs the Staff Is
Prepared To

• Remove the child from known triggers
• Help the child rest in a sitting position
• Help the child to relax
• Help child to calm self
• Calm other children
• Administer medications as needed

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Continue

• Have child blow into the peak flow meter if age
  appropriate
• Call emergency contacts
• Stay with the child and observe closely until
  help arrives
• Document the episode , actions and use of
  medication

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Responsibilities of the Physician

• Assess the child care setting
• Train the parents and child care provider
• Review and approve medications
• Act as a resource
• Develop an asthma plan and explain as needed

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Responsibilities of Parent and Child

• Understand the childs asthma management
• Ensure that the child care provider is thoroughly
  trained
• Notify child care provider of any changes
• Help the child describe their symptoms

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How to Decide if a Child Should Go to Child
Care May Go if Signs and Symptoms are limited
to

• Stuffy nose, but no wheezing
• Wheezing goes away after medication
• Ability to do usual activities
• No extra effort to breathe

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The child Should stay Home if These Symptoms are
Present

• Infection, sore throat, or swollen, painful neck
  glands
• Fever face is hot and flushed
• Wheezing or coughing after asthma medications
• Difficulty with activities
• Breathing with difficulty or breathing fast

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Five Emergency Signs

• Chest and neck muscles are working hard
• Struggling to breathe
• Trouble walking or talking
• Peak flow rate gets lower, or does not improve
  after treatment and
• Lips or fingernails are gray or blue (late sign
  in very young children)

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If you see any of these emergency signs, call 911
immediately and activate emergency procedures.
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What Is Good Control

• No coughing
• No waking at night
• No shortness of breath
• Normal respiratory rate
• No wheezing or chest tightness
• Normal lung functioning

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Managing the Child With Asthma

• Regular assessment and monitoring
• Control of factors that contribute to symptoms
  and severity of episodes
• Pharmacological therapy
• Educating the child, family and caregivers to
  adhere to written asthma management plan

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Two Asthma Management Plans

• A daily Management Plan--explaining regular
  medications and measures for control of asthma
• An Action Plan--describing actions to take

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Three Actions to Help Control Asthma

• Learn what triggers or starts or prompts asthma
  symptoms and avoid them
• Respond quickly to warning signs
• Make sure you have two working management plans

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Develop

• Strong partnerships with parents and physician
• Phone numbers and resources readily available

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Summary for Managing Childhood Asthma Are

• To Control asthma by reducing environmental
  triggers
• Promote a healthy lifestyle including proper
  rest, exercise, and nutrition
• Ensuring the proper use of medication

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Summary

• To foster emotional health so the child views
  self as a healthy and confident
• To prevent symptoms when possible
• To inform all relevant personnel and provide
  training as needed

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There is No Cure At Present

• Asthma can be controlled
• We should expect nothing less
• Remember Asthma is as much a disease of
  communication as inflammation
• Education programs are available to support child
  care providers

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So what is the good news in all of this?
Almost all children with asthma can be free of
symptoms with proper treatment and
management. Vision for the 21st Century Every
child in America will live, learn, work and play
in environments and setting that do not cause
or worsen asthma

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There are no such things as incurables
there are only things for which man
has not found
a cure. Bernard M. Baruch, 1870-1965