The Pediatric Asthma action plan is developed to help pediatric patients gain considerable control over the disease. it helps to strengthen the patient's awareness of their well being and allows them to take the best action at every point in time so that the frequency of exacerbations are reduced and also the morbidity and mortality associated with pediatric asthma is brought down to the barest minimum (Ducheme et al, 2011). The action plan includes a list of the mediations to take, the dosage of the medications, the periods during which the medications should be taken, things to do during an emergency and a list of possible triggers of asthma (Ducheme et al, 2011).
The medications are divided into Quick-relief preventers, quick relief medications and flare-up medications. The quick-relief medications are those taken in order to reduce the symptoms of asthma temporarily. They are most times needed for emergency situations. They include Albuterol inhaler. The flare-up medicines are taken to reduce the symptoms of asthma in the medium term, which spans days. They include Prednisolone. The controllers (or preventers) are needed to reduce the symptoms of asthma in the long term (NIH, 2007).
Generally, three zones are described to correspond to the level of well being of the patient. These include the Green zone, the Yellow zone and the Red zone (NIH, 2007).
The green zone connotes that the individual is doing well; with no cough, shortness of breath or chest tightness. The Peak flow is within 80 - 90% of the individual’s personal best. In this situation, the patient is advised to use their control medications daily and avoid activities that increase their asthma symptoms (NIH, 2007).
The yellow zone is described as the presence of slight cough, some chest tightness or some shortness of breath. The peak flow reading is also between 50 - 60% of the patient's personal best. In this situation, the goal of the patient is to get back into the green zone which involves calling the Nurse or doctor if the symptoms do not get better (NIH, 2007).
The Red zone connotes a flare-up when the patient has a persistent cough, is short of breath and generally if symptoms are not getting better after two days of being in the yellow zone. The patient takes the quick relief medicines. The process is repeated after 20 minutes if the symptoms persist. The flare-up and control medications are also taken (NIH, 2007).
It is important for the patient to know situations that trigger their asthma symptoms. Once these are identified, the patient is advised to limit exposure to these situations in order to remain in the green zone. The ultimate goal is for the patient to remain in the green zone (NIH, 2007).
Some common allergies have been identified as triggers of asthma. These allergies differ from one individual to another. Dust mites, pets, cockroaches, moulds and pollen have all been identified as allergens that could trigger asthma. Also, air pollutants, including other irritants can serve as asthma triggers. They include cigarette smoke, smog, some air-fresheners, aerosol sprays, and fumes. It is important that the patient is sensitive to their environment with a view to identifying if any of these pollutants serve as triggers to their asthma with a view to avoiding them (PACNJ, 2013), (NIH, 2007).
Infections can also serve as triggers to asthma. Pneumonia, Bronchitis, influenza and sinus infections can all serve as triggers (NIH, 2007) , (PACNJ, 2013). Therefore, if the patient comes down with any of these infections, they should be treated without delay so that they do not serve as triggers of asthma (NIH, 2007).
Physical activity helps the individual keep active (PACNJ, 2013), (NIH, 2007). They are helpful in keeping the body healthy. However, there are some situations in which physical activity can serve as a trigger. Therefore the patient should take precautions if they want to embark on any physical activity by using the quick-relief medicines shortly before embarking on physical activity (NIH, 2007).
REFERENCES
F Ducheme et al (2011). Written action plan in pediatric emergency room improves asthma prescribing, adherence, and control. Am J Respir Crit Care Med. 2011 Jan 15;183(2):195-203. doi: 10.1164/rccm.201001-0115OC. Epub 2010 Aug 27. Retrieved on 19th September, 2013 from <http://www.ncbi.nlm.nih.gov/pubmed/20802165>
PACNJ (2013). PACNJ Asthma Treatment Plan. The Pediatric/Adult Asthma Coalition of New Jersey. Retrieved on 19th September, 2013 from <http://www.pacnj.org/plan.html>
NIH (2007). Asthma Action Plan. Nationsl Heart, Lung and Blood Institute. U.S. Department of Health and Human Services. Retrieved on 19th September, 2013 from <http://www.nhlbi.nih.gov/health/public/lung/asthma/actionplan_text.htm>
