Healthy Children-Healthy Lungs

1. Healthy Children-Healthy Lungs Asthma in Children in Child Care developed by June Cuddihy, RN,CS,MSN Catholic Charities, Unified Child Care Program

2. “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~

3. 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

4. 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

5. 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

6. What to Look For • Anxious or scared look • Cough • Unusual paleness or sweating • Flared nostrils • Pursed lip breathing • Fast breathing

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

8. Coughing when the child has no cold Clearing the throat a lot Irregular breathing Wheezing Noisy, difficult breathing What to Listen For:

9. How to Listen: • Place your ear to the child’s back and hand on the child’s 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)

10. Signs of an Attack • Itchy, watery, or glassy eyes • Itch, sore throat • Sneezing • Congestion • Restlessness • Runny nose • Dark circles under the eyes

11. 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

12. 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

13. Types of Asthma Medications • Anti-allergy medications • Anti-inflammatory medications • Bronchodilators-rescue medications

14. Responsibilities of Providers: • Learn the basics of asthma • Consultant with the child’s parents, physician and your health consultant • Learn about the child’s symptoms • Learn about the treatment

15. 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

16. 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

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

18. Collect and Record Information: • Have forms completed by physician, that give exact information called an AsthmaActionPlan • Record medication and use your observation skills to identify the child’s symptoms

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

20. Continued • Keep all information in the child’s 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

21. 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

22. 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

23. 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

24. Responsibilities of Parent and Child • Understand the child’s asthma management • Ensure that the child care provider is thoroughly trained • Notify child care provider of any changes • Help the child describe their symptoms

25. 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

26. 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

27. 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)

28. If you see any of these emergency signs, call 911 immediately and activate emergency procedures.

29. 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

30. 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

31. Two Asthma Management Plans: • A daily Management Plan--explaining regular medications and measures for control of asthma • An Action Plan--describing actions to take

32. 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

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

34. 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

35. 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

36. 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

37. 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

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