Asthma Education: Family & Community Medicine - FCMD 613

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Family & Community Medicine

FCMD 613
Asthma Education

Done by:
Waleed Alsarhani
- Earn your five points:
1) Greet the parent/caregiver.
2) Introduce yourself.
3) Insure privacy.
4) Get the patient's name and age.
5) Explain the reason of the interview and gain consent

What is Asthma?
Asthma is a chronic respiratory disease induced by allergy with
o Reversible airway narrowing
o Airway inflammation
Symptoms
o Shortness of breath
o Wheezing
o Cough
o Chest tightness
Management
Avoid triggers
o Pollen/pets
o House dust mite
o Exercise
o Cold air
o Perfumes
o Smoking
o Dust
Medications
o Relievers
Inhaled Sulbutamol (Ventolin)

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Taken as required
Side effects: Tremors, palpitations and agitation
No risk of addiction
o Controllers
Inhaled Steroids
Used every day to prevent and minimize the symptoms
Side effects: Sore throat, hoarseness and oral thrush (hence rinse mouth
after use)

MDI Inhalation Technique


Recommended for patients > 5 years
MDI (Metered Dose Inhaler): It is a handheld device that delivers a specific amount of
medication in aerosol form, rather than as a pill or capsule.

Check expiration date.


Remove the inhaler cap.
Shake the inhaler.
Hold the inhaler upright with your index finger on the top and thumb on the bottom.
Breath out fully
Put the mouthpiece in your mouth, with the lips sealed around the inhaler and press
canister.
Start breathing in slowly and immediately press the inhaler button
Hold your breath for 10 seconds.

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Wait for 30 seconds until giving the next dose.
Wipe mouthpiece and cover it.
Finally, rinse your mouth (Only for inhaled corticosteroids to prevent oral thrush)

Spacer MDI Inhalation Technique


Spacers may be used in children, those experiencing side effects from inhaled
steroids or people having difficulty with inhaler technique. Spacers prevent escaping of
medications and therefore decrease inhaled steroid side effects i.e. thrush, hoarseness and
sore throat.

Technique
o Check the expiration date.
o Remove the inhaler cap.
o Shake the inhaler and insert it into the end of the spacer.
o Position the spacer in the childs mouth with the lips forming a tight seal.
o Press down on the inhaler.
o Ask the child to take a slow deep breath for 10 seconds
o Wait for 30 seconds between doses.
o Wait at least for 10 minutes when using two or more types of inhalers.

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o Finally, clean the mouth of the child with wet cotton. (Only for
inhaled steroids)

Looking after the spacer:


o Should wash spacer with warm water and soap and leave to drip dry before
using for the first time. (This is done every month)
o Repeat every month
o Make sure you don't towel dry as this will change the static in the spacer so it
won't work as well.
o Replace the spacer every 6 months to 1 year

Demonstration & Observation


Demonstrate it yourself.
With a different placebo inhaler, ask the patient to demonstrate how they would use
it.
Observe the patient and correct any mistakes.
Get the patient to repeat until they do it correctly.

Special Notes
Before explaining the inhalation technique tell the patient why the medication is
used and what its effect.
Explain about machine and its parts.
Tell patients about spacer and its benefits.
If using 2 types, use dilator first.
Dont forget to demonstrate and observe.
Encourage patients to ask questions

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Arrange for follow up

References:
OSCE-aid.com
Respiratory Block Patient Doctor Hand Book
OSCEstop.com
WV Asthma Education and Prevention Program
Osce-skills
Patient.co.uk
Asthma Society of Canada
WebMD

Note: This document is a personal effort and is subject to any mistake

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