Role of Parents

• Generation of idea
  During leisure time look for opportunities to discuss or even demonstrate ways in which the child can learn asthma management plan to circumstances likely to occur at school or home. Instead of training directly on do's and don'ts (it may frighten the child) start talking by asking "what would you do?" . It will spark imaginations and reveal much more than expected by children. "What would you do if you are monitor of the class and see a boy having asthma attack and teacher is away?" The "What would you do" questions should eventually lead to, "What do you think you will do if you have hard time breathing at school?" Don't forget to praise thoughtful and correct answers.
• Coping the stress of attending the school
  The child suffering from asthma may be stressful while going to school, particularly if he feels insecure about coping with his asthma in the school. Parents are ease some of the back-to-school flutters by discussing the situations that might arise. Remind the child that asthma seldom "attack" without warning, and encourage awareness of these warning signals that precede asthma attack.
  Explain what to do when there are early warning signals so that quite early action can be taken to avoid an embarrassing situation later on in the classroom.

Role of Asthmatic Child

• Identification of warning signals in asthma
  You must have seen traffic lights viz. Red, green and yellow. Red means stop and green means to go ahead. Yellow means careful and it gives a signal that light is going to change into red. The human bodies also gives us signals like a yellow traffic light before a fatal episode similar to red traffic light.When we are hungry stomach growls and when it is late, we feel tired and exhausted. These are warning signals of body. Children often get asthma warning signals that warns of asthma attack. These signals are like yellow traffic light that means be careful and do something urgently to manage the problems of coughing and wheezing. Most children suffering from asthma have warning signals hours before symptoms appear. Warning signals are not the same for every child. A child should recognise his warning signals. 

Take treatment regularly if you have any of the following

• Cough and wheezing  once a day.
• Episodes of breathlessness > Twice/week.
• Night disturbed by asthma > Twice/week.
• Daily minimum peak flow < 80% of the personal best.
• Work loss days > 2/month.

Action Plan when you perceive Warning Signals
When you perceive warning signals of an asthma attack you may take following steps to contain forthcoming asthma attack.

• Non-medicinal steps
  • Stop exposure to the trigger factor if any.
  • Move to a place which is not crowded and does not have smoke, fumes or dust.
  • Rest and relax.
  • Avoid exertion, loud speaking and laughing.
  • Take hot drinks such as tea and sip it slowly.
  • Tell your parents that you are going to have asthma.
  • Measure your peak flow.
• Medicines
  • Take your puff of Beta Agonist. Initiate or increase inhaled steroids. If your symptoms are not controlled with medicine in 1-2 hours, you should consult a doctor.

Identification of Frigger Factors
What induces an asthma attack in an asthmatic child? In healthy state the asthma is dormant and child feels perfectly normal. When a trigger factor comes in contact with such a child it activates dormant asthma and the child suffers from an episode of asthma attack. Unknown enemy is much more dangerous than a known enemy. You can defeat a known enemy but no one can defeat an unknown enemy. Therefore, the identification of trigger factors like enemies is very important step in defeating asthma. Trigger factors can be identified by adopting following methods,

• Past experience
  By thinking you may be able to suspect a number of factors which have caused asthma attack in the past. You may be able to relate an attack of asthma to preceding use of blankets or clearing or grains or to a sore throat. Seasonal variation in asthma severity strongly indicate mold spores or  pollens.
• Allergy testing
  • Skin prick testing
    Injections of various allergens are administrated in the skin. If a child is allergic to some allergen it will produce a swelling but a trigger allergen usually produces a swelling more than 5mm diameter. If you never get an asthma episode after coming in contact with an allergen identified in prick testing, it means false positive. You should not avoid such false positive substances. Usually skin prick testing for food allergens provide higher number of  false positive hence it is less reliable for identification of food allergen.
  • Blood testing
    By measurement of specific immunoglobin (IgE) level in the blood common allergens can be identified. However, it is time consuming and more expensive. For inhaled allergens there appears to be no advantage over skin prick testing. Therefore, the role of blood IgE testing is limited for young infants and for individuals who may be sensitive to food proteins. In such situation it may sometimes identify important triggers.
• Peak flow charting
  Fever is measured by thermometer. Similarly severity of asthma is measured by a peak flow meter. Daily record of peak flow taken in morning and night gives an accurate assessment of severity of asthma. Lower values of morning peak flow on any day suggest exposure to a trigger factor on the previous day. A child should make a list of the suspected trigger factors on the day of lower peak flow and write in the chart as given below. Trigger factors on various lower peak flow days are screened periodically to search common trigger factors. Repeated appearance of a factor in the chart confirms the incriminating trigger factors.

Defeating Trigger Factors
The technique of defeating trigger factors is given in the trigger factor series.