Childhood Asthma Treatment: Using a Pediatric Asthma Action Plan

Parents will tell you each of their children is different. While they may have similarities to their siblings or other children their age, each child also has their own quirks and needs. This also holds true when it comes to pediatric asthma, as known as childhood asthma. While pediatric asthma cases have similarities based on the mechanics of the illness, the method used to control the asthma symptoms will vary depending on the individual child.

Childhood Asthma Treatment: Meeting Your Child's Needs with a Pediatric Asthma Action Plan
A pediatric asthma action plan, also called a management plan, is a written plan developed by a family doctor or allergist together with of the parents and child. It records the child's personal asthma symptom triggers, medications used to treat their condition, steps to take to prevent asthma symptoms, actions required during an asthma attack, plus the daily and long-term goals of treatment. Information for emergency contacts, such as family members and doctors, should also be included on the written asthma action plan.

Once the plan is developed and written, parents should make copies available to all individuals who will help care for their child. This includes relatives, babysitters, teachers, and coaches.

A sample action plan is available online through the National Heart, Lung and Blood Institute in both a downloadable PDF file and a webpage version for easy printing.

Childhood Asthma Treatment: Pediatric Asthma Action Plan Guidelines
Most pediatric asthma action plans are divided into sections such as Green (well-controlled asthma), Yellow (symptoms are present, additional care is needed) and Red (medical assistance is required).

The goal of any form of childhood asthma treatment, whether an action plan is used or not, is to reach the following well-controlled asthma guidelines:

• No symptoms (such as coughing, wheezing, tightness in chest or shortness of breath)
• Few or no asthma attacks with minimal use of quick-relief inhalers (commonly known as rescue inhalers)
• No limitations on usual activities, such as running, playing or other forms of exercise
• Peak flow meter readings of 80% or better

A peak flow meter measures the amount of air a child with asthma can breathe out. The higher the percentage, the less narrowing and obstruction there is in the airways.

Parents should compare the Green, Yellow, and Red asthma guidelines with their child's symptoms on a daily basis, and then follow the recommended steps included on the plan.

Childhood Asthma Treatment: Pediatric Asthma Symptom Triggers
Many childhood asthma attacks are due to allergic reactions. A pediatric asthma action plan should list the known allergens, along with steps to remove or avoid them.

Common triggers for childhood asthma symptoms:

• Food (especially dairy, tree nuts, peanuts, eggs, and wheat)
• Pet dander
• Mold
• Pollen
• Chemicals (including perfumes and scented cleaning products)
• Tobacco smoke
• Medications

Allergy testing by a specialist may be required to determine which items are causing a child's asthma symptoms.

Childhood Asthma Treatment: Medications for Pediatric Asthma Control
Medications are often required to control childhood asthma. Depending on the severity of a child's personal asthma symptoms, these medications may range from simply using quick relief inhalers for coping with an asthma attack to long-term use of daily control medications.

Each medication, its dosage, and when to use it, should be listed on the pediatric asthma action plan.

Quick relief medications:
During an asthma attack, the muscles around the bronchial tubes constrict. This narrows the airways and makes breathing difficult. Quick relief medications, known as short-acting bronchodilators, relax these muscles and allow the child to breathe more easily. The medication usually works within a few minutes and last for up to six hours. The most commonly used rescue medication is Albuterol.

In some cases, doctors will prescribe oral corticosteroids for quick relief of a pediatric asthma attack.

Long-term control medications:
In more severe cases of childhood asthma, long-term medications may be required to control symptoms and prevent frequent asthma attacks. These include:

• Anti-inflammatory medications, which reduce swelling within the airways and make them less sensitive to asthma symptom triggers
• Inhaled corticosteroids, also used to reduce inflammation within the airways
• Long-acting bronchodilators, which control the response of the muscles around the airways for up to 12 hours
• Oral leukotriene modifiers, which prevent airways from swelling and stops the production of the excess mucus that commonly obstructs breathing during an asthma attack.

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Sources:
American Academy of Allergy, Asthma & Immunology
Tips to Remember: Childhood Asthma

Asthma and Allergy Foundation of America
What You Should Know About Childhood Asthma

Centers for Disease Control and Prevention (CDC)
Asthma Action Plan

Mayo Clinic
Childhood Asthma - Treatment and Drugs

New York City Department of Health and Mental Hygiene
Leukotriene Modifiers

University of Maryland Medical Center
Asthma - Pediatric - Overview
Asthma - Pediatric - Treatment

WebMD
Developing an Asthma Action Plan
An Asthma Action Plan for Your Child