Instructions

• Instructions for new users

Call 911 Now If:

• Severe difficulty breathing (struggling for each breath, unable to speak or cry because of difficulty breathing, making grunting noises with each breath)
• Your child passed out or has bluish lips/tongue
• Wheezing started suddenly after medicine, an allergic food or bee sting

Call Your Doctor Now If:

• Your child looks or acts very sick
• Looks like he did when hospitalized before with asthma
• Difficulty breathing not resolved 20 minutes after neb or inhaler
• Peak flow rate < 50% of baseline level (personal best)
• Peak flow rate 50-80% of baseline level after using neb or inhaler
• Wheezing (heard across the room) not resolved 20 minutes after using neb or inhaler
• Continuous (nonstop) coughing that keeps from playing or sleeping and not improved after using neb or inhaler
• Asthma medicine (neb or inhaler) is needed more frequently than every 4 hours
• Fever >104°F (40°C)
• Severe chest pain

Call Your Doctor Within 24 Hours If:

• You think your child needs to be seen
• Lots of yellow or green nasal discharge now with a fever
• Sinus pressure or pain
• Fever present > 3 days

Call Your Doctor During Weekday Hours If:

• You have other questions or concerns
• Missing > 1 day of school/month for asthma
• Asthma limits exercise or sports
• Asthma attacks frequently awaken from sleep
• Uses more than 1 inhaler/month
• Mild wheezing persists > 5 days
• No asthma check-up in > 1 year

Home Care (Read "Call Your Doctor…" first):

Asthma Rescue Medicine

• Start your child's quick relief medicine (e.g. albuterol inhaler or nebs) at the first sign of any coughing or shortness of breath. Don't wait for wheezing. (Reason: early treatment shortens the asthma attack)
• The best "cough medicine" for a child with asthma is always the asthma medicine
• Continue the asthma rescue medicine until your child has not wheezed or coughed for 48 hours

Asthma Controller Medicine

If your child is using a controller medicine (e.g. inhaled steroids or cromolyn), continue to give it as directed.

Hay Fever

For nose allergy symptoms, it's OK to give antihistamines.

Fluids

Encourage drinking normal amounts of clear fluids (e.g. water). (Reason: keeps the lung mucus from becoming sticky).

Humidifier

If the air is dry, use a humidifier. (Reason: to prevent drying of the upper airway).

Avoid or Remove Allergens

Give a shower to remove pollens, animal dander, or other allergens from the body and hair. Avoid known triggers of asthma attacks (e.g., tobacco smoke, feather pillows, exercise).

Expected Course

If treatment is started early, most asthma attacks are quickly brought under control. All wheezing should be gone by 5 days.

Call Your Doctor If:

• Inhaled asthma medicine (neb or inhaler) is needed more often than every 4 hours
• Wheezing is not completely cleared by 5 days
• Your child becomes worse or develops any of the "Call Your Doctor…" symptoms