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You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD Pediatric Cairo

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Page 1: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

You can make a difference in the health and welfare of a child

with asthma

Dr. Mourad A. TadrosFRCPCH (UK)

MRCPI (Dublin)

Member of ALS Group (UK)

MD Pediatric Cairo University

Page 2: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Learning Objectives

• The scope of asthma• Common asthma symptoms• Potential asthma triggers• The difference between quick-relief and

controller medications for asthma• How to manage an asthma episode• How to respond to an asthma emergency• The importance and components of an

Asthma Action Plan

Page 3: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

How Many Kids Have Asthma? 7 Million people in Egypt have asthma• 4,630,010 adults have asthma. That’s equal to 1 in 10

adults.• 2,369,990 children have asthma. That’s equal to 1 in 14

children.

Page 4: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

The Good News

Asthma can be controlled! Children with asthma are just like any

other child! Children with asthma can play sports

and compete just like everyone else!

Page 5: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

The Goal of Asthma Management

• “Children should live happy, healthy, physically active lives, without asthma symptoms slowing them down”

Page 6: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

What is Asthma?

A chronic disease that causes obstruction: Tightening of the muscles surrounding the

airways. Swelling of the lining of small airways in the

lungs. Airways that are overly sensitive to allergen

and irritant triggers. Over production of sticky mucus clogging the

airways.

Page 7: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Airway Obstruction

Page 8: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Symptoms

A Lot Going On Beneath The Surface

Airflow obstruction

Bronchial hyperresponsiveness

Airway inflammation

Page 9: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Truth

Asthma can be

cured in children,

only controlled in

adults

Myth

Asthma is n

ot

curable in

children

Page 10: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 11: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Truth

Controller medications work

best when used daily.

Use of daily Quick Relief (Salbutamol)

inhalers is an indicator of poor asthma control

MythAsthma medication becomes ineffective

if used regularly

Page 12: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Common Symptoms of Asthma

Frequent cough, especially at night Shortness of breath or rapid breathing Chest Tightness Chest pain Wheezing Fatigue Behavior changes

Page 13: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 14: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 15: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Every Child is Unique!

Wheezing and coughing are the most common symptoms.

No two children will have the exact same symptoms or the same trigger.

Every child who has a diagnosis of asthma should have access to a quick-relief inhaler!

Every child who has asthma should have an asthma action plan (AAP).

Page 16: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Asthma Action Plan

• Provides details on types of medications, when and how often to use

• What to do when symptoms worsen

• When to seek emergency help

• Form is completed by the child’s physician

Page 17: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Asthma Attacks and Episodes

Page 18: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

What’s An “Episode”?

Occurs when a child is exposed to a trigger or irritant and their asthma symptoms start to appear.

This can occur suddenly without a lot of warning, or build up for several days before the symptoms begin.

Episodes are preventable by avoiding exposure to triggers and taking daily controller medications (if prescribed).

Page 19: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 20: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 21: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 22: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

How Do I Handle An Asthma Episode On The Field/Gym?

1. Remain calm and reassure the child.2. Check the child's asthma action plan or

emergency card for actions.3. Give “quick-relief” medication(s) if ordered

and available.

Page 23: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Handling An Episode cont..

4. Have the child sit up and breathe slowly - in through the nose, and out through pursed lips slowly.

5. Have the child sip room temperature, water/ fluids.

6. Contact the parent or guardian as necessary. 7. DO NOT leave the child unattended.

Page 24: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

CALL Dr. Mourad if !!!

Lips or nail beds are bluish. Child has difficulty talking, walking or drinking. Quick relief medication (Salbutamol) is ineffective

or not available. Neck, throat, or chest muscles are pulling in

(retracting). Nostrils flare out when trying to breathe. Obvious distress. Altered level of consciousness/confusion. Rapidly deteriorating condition.

Page 25: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 26: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 27: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 28: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Exercise Induced Bronchospasm(Exercise Induced Asthma)

Page 29: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 30: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 31: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 32: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 33: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 34: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 35: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Sports affecting Asthma

• Football

• Handball

• Basketball

• Running

• Cycling

• Swimming

• Squash

Page 36: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Preventing EIB

Make sure your athletes give you an Asthma Action Plan - Keep it with you on a clipboard.

Athletes should use quick-relief medication (Salbutamol) 15 -30 minutes before strenuous activity begins.

Do warm-up (5-15 minutes) and cool-down exercises before and after activities.

Check outdoor air quality levels - the local forecast Stay hydrated! Dehydration can exacerbate the issue. Do not allow other athletes to tease or berate the

athlete having asthma symptoms.

Page 37: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 38: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Olympians

• A study in the November 1998 Journal of Allergy and Clinical Immunology found that– 1 in 6 athletes representing the United States

in the 1996 summer Olympics had asthma.– Thirty percent (30%) of the athletes with

asthma took home team or individual medals.– They fared as well as athletes without asthma

(28.7%) who earned team or individual medals.

Kidsgrowth.com - www.kidsgrowth.org/resources/articledetail.cfm?id=1262

Page 39: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Pro’s Who Have Asthma

Isaiah Thomas – NBA Jerome Bettis - NFL Dominique Wilkins - NBA Gary Roberts - NHL Donnell Bennett - NFL Amy Van Dyken - Olympic Gold Medalist

(swimming) Jackie Joyner-Kersee - Olympic Gold Medalist

(track & field) Greg Louganis - Olympic diver

Page 40: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 41: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Medications

Page 42: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD
Page 43: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Stepwise Approach for Managing Asthmain Children 0 to 4 Years of Age

Page 44: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Stepwise Approach for Managing Asthmain Children 5 to 11 Years of Age

Page 45: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Stepwise Approach for Managing Asthmain Children 12 Years of Age and Adults

Page 46: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Take Home Message

Get and use an Asthma Action PlanKnow symptoms and Peak Flow readings for

each of the green-yellow-red zones. Take “controller” medicine daily.Avoid exposure to triggers. Find a healthcare provider you trust and go in

for asthma check-ups at least twice a year.Tell your coach and teammates about your

asthma.

Page 47: You can make a difference in the health and welfare of a child with asthma Dr. Mourad A. Tadros FRCPCH (UK) MRCPI (Dublin) Member of ALS Group (UK) MD

Everyone Wins When An Athlete Plays Their Game To The Fullest!