A nonprofit independent licensee of the Blue Cross Blue Shield Association
Managing
Your Asthma
© Excellus Health Plan, Inc. 2010
Contents
Introduction............................................................................................1
Goals......................................................................................................1
What is Asthma......................................................................................2
Asthma Signs and Symptoms..................................................................3
Asthma Triggers...................................................................................3-4
Asthma Treatment..................................................................................5
Medications.........................................................................................5-6
Inhaler/Nebulizer..................................................................................7-9
Peak Flow Meter...................................................................................10
Asthma in School..................................................................................10
Asthma In the Workplace......................................................................11
Traveling with Asthma..........................................................................12
Croup...................................................................................................12
Asthma Diary........................................................................................13
Introduction
Working with your doctor
Feeling comfortable talking with your doctor is an important step to managing your
asthma. This will help you play an active role as a team member with your doctor.
Good management of your asthma will allow you to take charge of your life.
Here are some tips to help with asthma management:
G Learn what asthma is and what your triggers are.
G Take your medications as prescribed.
G Learn to use the devices correctly.
G Keep an asthma diary that includes symptoms, activities and peak flow readings
(if you are measuring peak flow).
G Obtain a yearly flu vaccine. If possible, have all family members get a flu vaccine.
G Talk with your doctor regarding a pneumonia vaccine to see if you are a candidate.
G Work with your doctor to see if an asthma action plan is needed.
G Understand any changes in the asthma treatment and/or asthma action plan.
G Make a list of questions or concerns prior to your doctor’s appointment.
G Schedule a doctor’s visit just for asthma at least every six months.
Tell your doctor
G How often you are using your rescue inhaler.
G What asthma symptoms you have.
G How often nighttime symptoms occur.
G If your asthma is limiting your ability to exercise, work, attend school or do other
daily activities.
Goals
Goals of asthma care:
G No asthma symptoms day or night.
G No missed school/work/home activities.
G Maintain normal or near-normal lung function.
G Little or no use of rescue inhaler.
G No adverse effects from medications.
1
What Is Asthma
What is normal breathing?
Here is what happens:
Normal breathing is when air (oxygen)
comes in through your nose and mouth
and goes through your airways to your
lungs. The air ends up in small sacs called
alveoli in your lungs. When you breathe
out, you get rid of carbon dioxide from
your body.
Inflammation
What is asthma?
Asthma is a chronic inflammatory
disorder of the airways. Inflammation
and tightening in the airways of your
lungs make it hard for you to breathe.
With asthma, inflammation is always
present, but you may not notice it until
you come in contact with a trigger.
Asthma flare-ups can be
related to many different
causes
It is not known why some people have
asthma and others do not. Heredity
may be the reason for many people. For
others, allergens or irritants in the air
can trigger an allergic reaction, causing
asthma to flare up. However, no matter
what the cause is, we do know the basic
problem is inflammation and constriction
of the airways.
*****Plants with pretty flowers are
typically insect-pollinated. Very little of the
pollen becomes airborne to cause allergy
symptoms.
2
The cells of the inside walls of the
airways become swollen and irritated.
As these cells swell, they rupture and
leak fluid into the airways. This produces
a thick mucous, making the airways
smaller and more difficult for the air to
pass through into the lungs.
Tightening (constriction)
There are also muscle bands that
surround the airways. They help to
hold the airways open so air can pass
through. When they cannot expand any
further because of the swelling, they
twitch (bronchospasm) and squeeze with
each breath. The tightening causes the
airways to become narrow so air cannot
get through. This may cause you to feel
tightness in your chest.
Some of the airways are so tiny that
there is not much room for swelling
and mucous. The mucous then plugs
the airways, which causes you to start
coughing and makes it difficult for
you to breathe. In some people, this
inflammation causes recurrent episodes
of coughing, wheezing, breathlessness
and chest tightness. These are warning
signs that something is wrong. You
should learn what your particular
symptoms are.
Allergic Asthma: Non-Allergic Asthma:
Triggered by inhaling or ingesting
an allergen that causes an allergic
reaction.
Trigger may be something irritating
the airways rather than an allergen.
Pollen from trees, weeds, grass
Anxiety, stress, crying
Dust mites Exercise
Mold spores
Cold air or dry air
Cockroaches
Hyperventilation
Animal dander
Cigarette smoke or campfire smoke
Food allergies
Viruses
Aspirin or other non-steroidal antiinflammatory medication
Chemical fumes
Insect stings
Perfumes and scented candles
Non-A
Heartburn and GERD
(gastroesophageal reflux disease)
Asthma Signs And Symptoms
An asthma attack can happen suddenly or over a few days. These symptoms can occur anytime.
It is important to know what triggers
your asthma symptoms. Talk with your
doctor if your asthma is not controlled.
Asthma cannot be cured, but it can
be controlled with medications and
scheduled visits to your doctor. It is
important to work with your doctor to
develop an action plan. An action plan
will include instructions of what to do
when symptoms occur.
Allergy symptoms
• Sneezing.
• Runny nose.
• Stuffy nose.
• Coughing.
• Itchy, watery eyes; itchy nose
and roof of mouth.
• Dark circles under eyes.
Symptoms may include
• Breathing fast.
• Having less energy.
• Waking at night.
• Wheezing – a whistling noise with breathing.
• Constant cough with or without
mucous.
• Shortness of breath.
• Tightness in the chest.
Some asthmatics also have allergies to
food, medicine, insect bites or latex. Your
doctor may prescribe an Epipen for a
severe allergy. This medication should be
used at the earliest sign of severe allergy.
You should always carry it with you.
G
When a severe asthma attack
or allergy attack occurs, get
Asthma Triggers
An asthma trigger sets off your asthma
Here are some triggers and how to avoid or control them.
Animal Dander - dried saliva on
fur or feathers of pets can increase
asthma symptoms.
What to do
Keep pets outdoors if possible; keep
them out of the bedroom and away
from carpeted surfaces.
Keep bedroom doors closed.
Keep pets away from cloth furniture
and carpets.
Bathe animals often.
Consider shorthaired or
non-shedding pets.
• Difficulty talking.
• Blue-colored lips and/or grayishcolored skin.
• Using neck or chest muscles to
breathe.
• Coughing that leads to vomiting.
Signs of a severe
allergy attack include:
• Itching or hives within minutes.
• Swelling of the lips, face and tongue.
• Difficulty swallowing or drooling.
• Dizziness or fainting.
• Vomiting.
• Trouble breathing.
help and call 911.
Allergens
A severe asthma attack
can include:
Dust Mites - tiny bugs found in
mattresses and pillows, cloth
furniture, carpeting. Many people
with asthma react to dust mite
droppings.
What to do
Cover mattresses and pillows with
allergy-proof covers.
Wash sheets, pillowcases and blankets
weekly in hot water that is at least
130ºF.
Keep humidity in house low.
Vacuum often with a HEPA (high
efficiency particulate air) filter.
Damp-mop non-carpeted floors
frequently.
Replace curtains or drapes with blinds,
if possible.
Keep stuffed toys to a minimum and
wash frequently.
3
Cockroaches - some people
with asthma react to cockroach
droppings.
What to do
Use closed containers for food not
stored in the refrigerator.
Keep garbage in closed container
outside of house.
Use pesticides cautiously and when
asthma patient is out of house.
Keep all poison bait away from
children and pets.
Pollen - budding trees, grass
and weeds may affect asthma
symptoms.
Irritants
Smoke - any form of smoke:
tobacco, wood stove, campfire
or barbecue can trigger asthma
symptoms.
What to do
If you smoke - quit.
If a loved one
smokes - encourage
him or her to quit.
Avoid secondhand
smoke in automobiles, homes and
other enclosed areas.
Limit exposure to wood stoves and
fireplaces. Make sure they are well
vented.
Do not store wood inside, which will
also promote mold growth.
What to do
Stay indoors when pollen count is high
and during warmest part of the day.
Use air conditioning for filtering these
particles from household air.
Shower and shampoo hair before
going to bed.
Avoid hanging laundry outside.
Molds - damp or moist areas of
your home promote mold growth.
Air irritants - small, invisible
particles in the air may cause
irritation in your airways.
What to do
Stay indoors, close windows and use
air conditioning during ozone alerts.
Avoid using perfume, scented hair
products, air fresheners and strongsmelling household cleaners.
Avoid burning scented candles.
What to do
Use exhaust fan when showering.
Check for and repair water leaks in
basements, inside walls and under
sinks.
Weather factors - weather
extremes may affect your asthma.
What to do
Use household cleaners that are safe
for the environment.
Wear a scarf over nose and mouth
during cold, dry weather.
Outdoor mold grows on falling leaves.
Avoid raking leaves or wear a mask
while raking.
Limit time outdoors during high
humidity and ozone alerts.
Eliminate areas of standing water
outside. This will decrease mold
growth.
Exercise - exercise can help
asthma and can cause flare-ups.
What to do
Speak with your health care provider
before starting an exercise program.
Provider may recommend medication
use prior to activity.
4
Try warming up for exercise, such as
slow walking.
Avoid outdoor exercise during
extreme weather (high humidity, high
temperature, frigid air).
Carry your rescue inhaler at all times.
Cold and respiratory infections can increase lung inflammation,
making it difficult to breathe.
Prevention is the key.
What to do
Talk with your provider about getting
an annual flu shot and a pneumonia
shot every 10 years.
Help prevent viral respiratory
infection by:
Frequent hand washing. Cover your
mouth and nose when sneezing or
coughing.
Disinfecting doorknobs, railings and
shared items, such as telephones,
keyboards and computer equipment.
Avoid sharing drinking and eating
utensils.
Other asthma triggers include
• Reflux - indigestion or heartburn.
• Emotions - laughing, crying, anger,
anxiety or stress.
Work place triggers - asthma
triggers in the work place
may be a result of fumes from
chemicals, paint, cleaning
products, exhaust, cooking and
baking products.
Also particles or smells from
carpeting, furniture and newly
painted or remodeled areas.
What to do
Report increased asthma symptoms
at work to your supervisor and health
care provider.
Wear a mask when chemicals are
being used.
Asthma Treatment
It is recommended that a specialist (allergist or pulmonologist) be seen if:
GYour asthma is not controlled.
GYour asthma episodes result in emergency room visits
or hospital admissions.
GAn asthma specialist may try other treatment and
testing options such as:
Pulmonary functioning tests.
GYou need more education about asthma.
Skin prick test for allergies.
GYou need more testing.
Blood test for allergies.
GYou are not meeting your therapy goals in three
to six months.
Medications.
GYou have other medical conditions that affect
your asthma.
Medications
Medications: How do they work?
Even though there is no cure for asthma, it can be controlled.
The goal:
Two basic categories of medications:
G reduce the need to use your rescue
inhaler.
Category 1
• Having difficulty sleeping.
G prevent asthma attacks from
occurring.
Corticosteroid medication:
Control medications.
Metered-dose inhaler devices, (MDIs) are
made to release a premeasured amount
of medication. MDIs deliver commonly
used asthma medication to help open
up the airways and make breathing
easier. They are especially important for
delivering quick relief medication in case
of an asthma attack. MDIs are also used
to deliver long-term control medications,
anti-inflammatory medication and longacting bronchodilators.
G They help to prevent and reduce
the swelling in your air tubes and
decrease the mucous.
Tell your doctor if you feel like this. He
or she may want to change your dose
or try a different medication.
G You will not feel anything
happening immediately after using
your controller medication, but
with continued use, you will notice
fewer symptoms of asthma and
less frequent need to use your
quick reliever medication.
G It is important that you take your
controller medication everyday as
prescribed for maximum benefit.
G Never use your controller
medications to relieve a sudden
asthma attack.
Side effects are uncommon:
• Oral thrush (yeast infection in
the mouth).
• Hoarseness.
• Sore throat.
• Nervousness.
• Nausea.
Be sure to rinse your mouth out after
using your medication to prevent
thrush and reduce hoarseness.
Some people do not like it when
they hear a medication has a steroid
in it. Corticosteroids are not the
steroids used by athletes. Those
steroids are called anabolic steroids.
Corticosteroids are safe to take for
your asthma.
Use of high-dose inhaled
corticosteroids.
• Parents may worry about the effect
on growth rate in their children
if they are on these medications
long term, but severe asthma that
is uncontrolled can also reduce
growth.
• Elderly patients who have been on
high-dose inhaled corticosteroids
may experience changes in their
bone density and skin thickness.
5
• These side effects are rare and less
likely than those of oral steroids.
Leukotriene antagonists: On
occasion, people are put on
these mildly anti-inflammatory
medications.
G Prevent airways from swelling when
they come in contact with an asthma
trigger.
G These non-steroids can also help
prevent asthma caused by exercise.
Long-acting beta 2 agonists Should not be used as a quick relief
medication for an asthma attack.
GShould not be taken without an inhaled corticosteroid.
GHelps control daily symptoms of asthma, including nighttime asthma.
GCan be used to prevent asthma
induced by exercise.
Frequently Asked Questions About
Asthma Medications:
Controller
Rescue
Medication Medication
Will I feel an immediate relief after using my inhaler? No
Yes
Is this medication used to stop an asthma attack?
No
Yes
Can this medication cure my asthma?
No
No
Can this medication be taken daily?
Yes
No
Can I use this medication before I exercise?
No
Yes
Will this medication help decrease swelling and mucous?
Yes
No
Should I prime my inhaler first before using it?
YesYes
Dry-powdered inhaler:
These inhalers release a fine dry powder with
a quick and steady deep breath. There is no
propellant to deliver the medication. These
devices are dependent on the force of your
inhalation to get the medication into your lungs.
GThere are commercially available
inhalers that contain both an inhaled
corticosteroid and a long-acting beta 2
agonist in one inhaler
Side effects: Usually minor.
Because it is a powder, much of the medication
is left in the mouth and throat as you breathe
it in, giving you a bad taste and even a little
irritation to the tongue and throat. Rinsing your
mouth out after every use will help eliminate this.
Oral corticosteroids (not anabolic
steroids) - The hospital or your
doctor may put you on this
medication short-term to help
get your asthma back under
control quickly.
You may also end up swallowing some of the medication that remains after rinsing,
which can cause a minor upset stomach or heartburn. If this should occur, be sure to
let your doctor know. Please note that many decongestants are not recommended for
use in children. These medications should not be used in children under 2 years of age.
Most products contain labels stating the medication should not be used for children
under 4 or 6 years of age.
• Used as short-term treatment when
you have a severe asthma attack.
• Quickly reduces inflammation.
Category 2
Quick relief medications
Short-acting bronchodilators Rescue medication.
G Help to stop an asthma attack after it
has started.
G Open airways by relaxing muscles
that tighten the airways during an
asthma attack.
G Help prevent expected asthma attacks
caused by exercise.
Side Effects:
• Nervousness.
• Rapid heart rate.
6
A more common side effect is a yeast infection or oral thrush in the mouth and throat,
which appears as a white coating of the mouth and throat. This is easily treated by your
doctor.
Allergy medication:
Antihistamines: Relieve sneezing, itching and runny nose. They work best if
taken routinely during the allergy season. They block the effect of histamine
(a substance made by the body during an allergic reaction).
Decongestants: Work by narrowing blood vessels and reducing fluid in the affected
area, which helps clear congestion and improve breathing. Oral decongestants relieve
stuffy nose and drainage. Please note that many decongestants are not recommended
for use in children. These medications should not be used in children under 2 years
of age. Most products contain labels stating the medication should not be used for
children under 4 or 6 years of age.”
Leukotriene [loo-kuh-trahy-een] modifiers: Are not steroid medications but are
long-term controller medications. They help reduce airway inflammation and swelling,
decrease the amount of mucous and open the airways.
The month before allergy season is the best time to start taking allergy
medication. Your doctor may recommend an allergy medication to help control
your symptoms, or he may recommend an over-the-counter allergy medication.
Inhaler/Nebulizer
How to use an inhaler
How to use a spacer
A metered dose inhaler, MDI, is a
device to deliver asthma medication
to your lungs.
Your doctor may recommend using a
spacer. It attaches to the inhaler. It holds
the medication in a chamber. A spacer
is recommended for use with all inhaled
corticosteroids. It is also suggested for
use with all MDI inhalers. Ask your
doctor what is best for you.
Prime
If this is your first time using an inhaler,
you will need to prime it. You should also
prime an inhaler if it has been longer
than two weeks since you last used it.
1. Take the cap off the mouthpiece.
1. Take deep breaths to inhale the dose
of medication and hold your breath.
2. Shake the inhaler for 5 seconds.
2. Repeat for second puff.
3. Press down on the canister, spaying
the medication into the air two times
(away from your face). Look to see if
a fine mist has been released.
Care of a metered
dose inhaler
Regular use
1. Remove cap and hold inhaler upright.
2. Shake inhaler five to 10 times to
mix medicine.
3. Attach spacer if indicated by your
doctor.
It is important to keep your inhaler clean
and ready for use.
1. Remove mouthpiece from canister.
Rinse after each use.
2. If the mouthpiece or spacer becomes
dirty, wash with mild soap and
warm water.
4. Take a deep breath, then exhale
completely.
3. Rinse well.
5. Place the mouthpiece in your mouth
if using the closed-mouth method.
6. Close your lips around it tightly.
5. Store inhaler in a cool dry place.
Avoid placing it in sunlight. Do not
store in car or near open flames.
7. When using the open-mouth
method, place inhaler 2 inches from
open mouth.
How to use dry powder
diskus-type inhaler
8. Begin to breathe in slowly while you
press down to release a puff
of medication.
9. Hold your breath for five to ten
seconds. This will allow medication
to get deep into your lungs.
10. Breathe out slowly.
11. Repeat puffs as directed. Wait two
to five minutes between puffs.
4. Always allow it to air dry completely.
1. The diskus inhaler is closed when you
open original package.
2. An indicator may tell you how many
doses are left.
3. Diskus inhalers may have an alert
when doses are getting low.
3. Push your thumb away from you until
mouthpiece appears.
4. When you have pushed as far as you
can, it will snap into place.
Click
1. Hold inhaler level and flat.
2. Mouthpiece should be toward you.
3. Slide the lever away from you until it
clicks.
4. Inhaler is now ready for use.
Inhale
1. Take a deep, cleansing breath.
Exhale fully.
2. Hold inhaler level.
3. Place mouthpiece to your lips.
4. Breathe in fast and deeply.
4. Numbers will appear in red when you
have about five doses left.
5. Take inhaler away from your mouth.
Taking a dose
7. The medication from this inhaler is a
dry powder.
Open
1. Hold inhaler in one hand.
2. Place thumb of the other hand on
the thumb grip.
6. Hold your breath for as long as you
can—at least 10 seconds.
8. You may be able to feel or taste it.
9. Rinse your mouth with warm water
and spit it out.
7
Close the inhaler when finished.
1. Place thumb on thumb grip. Slide it
toward you all the way.
2. It will snap shut.
3. The inhaler is now ready for your
next dose.
Important points for dry
powder inhaler
DO
Use inhaler in flat position.
Rinse your mouth after use.
Spit out rinse water.
Store inhaler in a dry place.
DON’T
Breathe into this inhaler.
Take inhaler apart.
Use with a spacer.
Wash mouthpiece of inhaler.
Take an extra dose if you do not taste
or feel medication.
How to use a twist-type
inhaler
Some twist-type inhalers need to be
primed the first time they are used.
Prime
Remember when using dry powder or twist inhalers:
DO
DON’T
Always hold inhaler level.
Shake inhaler after loading dose.
Always hold inhaler upright when
priming or loading.
Exhale into inhaler.
Always rinse mouth with warm
water after use. This will help
prevent fungal infections of the
mouth.
Wipe mouthpiece dry.
Swallow water you have rinsed
your mouth with.
Prime inhaler after the first use.
Hold inhaler at the top of the
mouthpiece.
Store in a dry place.
1. Hold inhaler upright.
2. Grasp colored part (bottom) in
one hand.
Use
3. Grasp top of inhaler and lift off.
1. Hold inhaler in upright position.
6. Close lips around mouthpiece.
4. Grasp inhaler on bottom, colored
part in one hand.
2. Twist bottom of inhaler all the way to
the right and back to the left.
7. Inhale as deeply and forcefully as
you can.
5. Grasp top of inhaler in the middle
with the other hand.
3. Inhaler will click.
6. Twist bottom as far as it will go to
right and then to the left.
5. Breathe out completely facing away
from the inhaler.
7. Then twist it in the other direction
until it clicks.
8. Twist back and forth again.
9. Priming is complete.
8
4. This loads a dose of medication.
8. Remove from mouth and exhale.
9. Replace cover.
10.Rinse mouth with warm water and
spit out.
How to use a nebulizer
A nebulizer uses air to make a mist of
your asthma medication. Breathe the
mist into your lungs.
1. Your medicine may already be mixed.
2. Open it and place in the cup.
3. Attach the mouthpiece to the cup.
4. Attach these to the tubing of
the machine.
5. Place mouthpiece in mouth.
6. If you use a mask, place it over your
mouth and nose.
7. Turn on the machine.
8. Take deep, slow breaths through
your mouth.
9. Try to hold each breath for
two seconds.
10. Continue until medication is gone.
This will be about 10 minutes.
Care of a nebulizer
Cleaning your nebulizer is very important. This helps prevent infections. Proper cleaning also makes the machine last
longer.
1. Remove mouthpiece or mask from the cup.
2. Remove tubing.
3. Wash all parts, except tubing and machine. Use mild dish soap and warm water.
4. Rinse completely with warm water.
5. Shake off excess water.
6. Place on dry, clean cloth or paper towel.
7. Allow to air dry.
8. Attach parts and run machine 10 to 20 seconds.
This will dry inside of machine.
9. Remove tubing. Store machine and parts in a
plastic bag.
19. Twice a week, soak parts (not tubing or
machine) in one part distilled white vinegar
and two parts water.
11. Soak for 30 minutes.
12. Rinse parts for one minute.
13. Allow to air dry.
14. Put parts together.
15. Run machine 10 to 20 seconds. This will dry
inside of machine.
9
Peak Flow Meter
The peak flow meter is a monitoring device that helps measure how
well air is coming out of your lungs. This measurement can be used to
find out if you have reduced airflow hours or days before you have an
asthma flare-up. This will allow you to use your rescue medication to
stop the flare-up quickly.
G Most common disease among
children.
The meter is easy to use. Take a reading before you take your asthma
medicine in the late afternoon or early evening.
Asthma In School
G Leading cause of missed school days.
It is very important to have a written
asthma action plan from your doctor if
your child has persistent asthma. If you
use a rescue inhaler only for gym class
or other sports, your doctor will write
instructions. Always notify the school
nurse of any illness.An asthma action
plan should include:
• medications and dosages.
• asthma symptoms.
• peak flow readings if used.
• triggers.
• Inhaler required before gym or recess.
Meet with the school staff yearly to talk
about the following:
• Asthma symptoms and triggers.
• Your child’s ability to recognize
symptoms.
• Emergency phone number for the
parent or guardian and doctor.
• Discuss the school rules for
medications.
• Who would be available to handle
asthma symptoms for upcoming field
trips?
How to use a peak flow meter
1. Hold the meter in your hand.
2. Move the pointer to zero.
3. Stand up.
4. Take a deep breath.
5. Place the meter in your mouth. Seal your lips around the mouthpiece.
6. Blow out as hard and fast as you can.
7. Write down the number at the pointer.
8. Repeat this two more times.
9. Record your best of three tries on your asthma diary.
The highest reading you can record is called your personal best reading.
Your doctor will use this reading for your asthma treatment.
10
• Changes in the classroom, such
as new pets (gerbils, hamsters),
construction, new cleaning products
or classroom supplies (paints,
glues, eraser dust).
New York state has a law in place that
allows children with severe asthma to
carry their quick relief medication with
them while in school. It is best to talk to
your doctor regarding these rules and
requirements.
Asthma In The Work Place
• Dust (dander) from animals
and insects.
• Dust from wood, latex gloves, flour
and poorly cleaned buildings.
• Mold in damp or water-damaged
parts of buildings.
• Physical stimuli (cold/heat, humidity).
Symptoms – Refer to ”Asthma Signs
and Symptoms”
Patterns of symptoms:
Improvement of symptoms occurs
during vacations or days off (may take
a week or more).
Symptoms may occur immediately
(less than one hour), delayed (most
commonly within two to eight hours
after exposure), or at night.
Initial symptoms may occur after
high-level exposure (for example,
chemical spills).
You may be exposed to many different
particles at work. Your employer should
give you information of possible danger
connected to your job. Your employer
should keep a healthy work place.
Special equipment may be needed to
protect you. Report any unhealthy work
conditions to your employer.
Some common jobs
with allergen or irritant
exposure:
Occupational asthma is worsening of
symptoms in workers with a previous
history of asthma. A worker with no
previous history of asthma can also
develop occupational asthma.
• Farmers, bakers and grain handlers.
Aggravated asthma is due to repeated
contact to dust and fumes. Being in
contact with these triggers is considered
an irritation to the lungs. Early diagnosis
and treatment may help end symptoms.
Each person has different triggers that
start asthma attacks. Some triggers in
the work place may include:
• Office workers.
• Construction workers, including
welders.
• Janitors and cleaners.
• Beauty salon workers.
• Teachers.
Triggers:
• Chemicals in paints, cleaning products
and other things. Refer to work place
triggers on page 4.
Once sensitized, patients with
occupational asthma may react to
extremely low levels of airborne
allergen.
What can you do?
Let your doctor know about your
current job and other jobs you
have had.
Keep a daily record of your symptoms
and asthma attacks.
Let your doctor know when your
asthma gets better or worse.
Avoid triggers.
Move to another work area.
Wear proper equipment.
You should work with your employer to
remove yourself from triggers.
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Traveling With Asthma
There are important things to do before
going away when you have asthma.
Your asthma should be controlled.
Remember that you may be in contact
with triggers when using public
transportation.
Carry your inhalers and other asthma
medications with you at all times.
Drink plenty of fluids when the air is dry
to help prevent symptoms.
Bring a list of medications and dosages.
Bring your doctor’s and pharmacy
name and phone numbers.
Traveling by car
Have enough medications to last the
whole trip.
Before traveling, run the air conditioner
or heater for 10 minutes while the
windows are open. This will help remove
any odors or dust in the vents.
Let family or friends know triggers
ahead of time.
Traveling by plane
Take a copy of your asthma action plan.
Find out pollen counts and
smog levels.
While traveling, your living space
should be:
• Smoke-free.
Check to see that it is a non-smoking
flight (outside of the U.S.)
Make sure that all medications have
the original prescription label.
• Pet-free.
Croup
What is it:
G Inflammation in the upper
airways—voice box and
windpipe.
G Caused by a virus.
G Most common in children
(six months to three years).
G Occurs in the fall/early winter.
G Contagious through coughing,
sneezing and close contact.
Signs and symptoms:
G Can start as a common cold,
stuffy, runny nose and fever.
G Child becomes hoarse with a
loud, harsh barking cough—like
a barking seal.
G Worse at night and when the
child is upset or crying.
G You may hear a high-pitched
or squeaking noise as the child
inhales (called stridor).
• Dusted.
• Vacuumed.
• Aired out.
G Breathing may be very fast and
may have retractions.
G Lasts two to five days.
G Dehydration can occur.
Treatment:
G Try to stay calm and soothe
your child.
G Fill bathroom with steam and
sit for 10 minutes, breathing in
moist air.
G Breathing cool, night air
may help.
G Humidifier in the child’s room
at night.
G Do not smoke.
G Keep child hydrated.
Resources
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G If symptoms do not improve in
30 minutes, call the doctor.
- Centers for Disease Control and Prevention
- New York State Department of Health
- National Heart, Lung and Blood Institute
- American Lung Association
Asthma Diary
This is a record of your peak flow readings, symptoms and medications. This log helps you and your doctor
manage your asthma. Complete this form and take it to your next doctor’s visit.
Week of:_______________________________________
My personal best is_____________________________
My green zone is_______________________________ liters per second (80% to 100% of my personal best*)
My yellow zone is______________________________ liters per second (50% to less than 88% of my personal best*)
My red zone is less than_________________________ liters per second (less than 50% of my personal best*)
* To figure out 80% of personal best peak flow, multiply your personal best by 0.80. To figure out 50% of personal best
peak flow, multiply your personal best by 0.50.
My current long-term medications are:_________________________________________________________________________
Date
AM PM peak flow
Trigger
Symptoms
Quick-relief medication Red zone visit
and response
to doctor
Green Yellow
Red
or hospital?
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This information does not replace the advice of a doctor.
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