Asthma Care

With approximately 200,000 asthmatics and an untold number of allergy sufferers in the Washington area, we all have friends, acquaintances or family members for whom wheezing, sneezing and itching are a way of life. But don’t be misled: allergies are devastating illnesses for the 10 percent to 15 percent with serious disease.

If you recognize the signs of a severe flare early there should be enough time to give a quick-relief treatment, call your physician, and get to an emergency department. Most asthma flares have a progression of symptoms over the course of hours, and traveling by ambulance should be unnecessary. Rarely, a child may develop sudden severe symptoms.

Warning signs of a severe asthma flare vary for individual children. As you know, flares occur when a trigger increases inflammation in the airways of the lung.

Emergency department care usually begins with an assessment at triage to determine the level of illness. For asthma, this includes vital signs (temperature, pulse and breathing rates, and blood pressure) and pulse oximetry, a small clip that attaches to a child’s finger or toe to measure the oxygen content of the blood.

Every child should have a primary care provider for well-child checkups and immunizations. With a chronic disease like asthma, it is particularly important to see consistently the same physician, nurse practitioner, or other professional over time so the primary care provider can get to know your child well. This primary care provider will play the lead role in assessing your child’s asthma, prescribing medicines, and making referrals for other services or specialty care if needed.

Build a private patient counseling room or set aside a semi-private area in your practice; Utilize a blackboard when conveying ideas; Look for simple, easy-to-read handouts from hospitals, drug companies and national asthma organizations. When I am given a brochure for children, I show it to my four-year-old.

Asthma care and medicines are expensive, and obtaining the right health insurance is an important first step in accessing the health care system. Recent changes in the law provide the opportunity for virtually every child in every state to qualify for some form of health insurance. The rules and steps involved are complex, however, and may leave many gaps in the care that is provided.

Specialty care for asthma can be confusing because each type of provider may have a different focus. Pediatric allergists specialize in the reactions of the immune system to common environmental allergens, such as pollens, dust mites, or pet dander, that can play a key role in asthma. Allergists use skin tests to detect allergies and may, in some cases, treat allergies by giving repeated small doses of the allergen.