for success lies with both patient and professional.
Responsibility for failure lies with the professional
and asthma program unless proven otherwise.
at a given site must agree on the essentials
of asthma education and asthma treatment. If
they don’t, they will have to spend a
lot of time explaining why their approach differs
from that of other professionals the patient
should take place at every contact of the patient
and professional: in the office, the emergency
department, the hospital ward and with the school
nurse. It will usually be one on one, last less
than five minutes and be specific to the patient’s
of concepts, content and vocabulary as used
in the 1997 NHLBI Guidelines will lead to more
effective and efficient education. Problems
occur when using a single word with different
meanings. For example, though professionals
in the same office refer to a wheeze as mild
they have not agreed on how to distinguish it
from one of moderate severity. Use of several
words to mean the same thing, such as quick
relief, reliever, rescue, fast acting beta agonist,
quick acting beta agonist, short acting beta
agonist, Ventolin or Proventil for albuterol
also causes confusion. Patient understanding
and effectiveness of the visit is enhanced when
professionals use the same vocabulary.
written materials for patients that share the
same language and concepts will bring consistency
to asthma care. One Minute Asthma, the Pedipress
asthma diaries and asthma action plans are designed
to complement each other. Dr. Tom Plaut’s
Asthma Guide for People of All Ages and the
1997 NHLBI Practical Guide for the Diagnosis
and Management of Asthma are excellent resources
should be of good quality, and a single brand
should be used for all patients. This will reduce
problems in instruction and during use. Since
professionals will only have to be familiar
with one brand of each device, troubleshooting
will be easy.
cups. The Pari nebulizer cups provide three
to four times the benefit of other commonly
used cups. More than 60% of the particles it
produces are in the respirable range, and very
little mist is lost on expiration. Treatment
is faster, better and cheaper.
flow meters. The most common problem is a falsely
high reading due to the “spit “
or “pea shooter” maneuver.”
This rarely occurs with the Mini-Wright, the
Astech or PocketPeak but is a problem with most
others. This problem can be avoided by placing
the mouthpiece on the flat of the tongue.
and Asthma Action Plans should be uniform across
the program to simplify instruction and interpretation.
Age specific tools should be used for the under-five
Use as few brands and inhaler types as possible
because techniques for use vary. Errors in technique
can cut effectiveness of treatment by inhaler
or compressor driven nebulizer by 80 percent.