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Asthma Management Startswith Asthma ScreeningsWhen you can’t breath, nothing elsematters.
Respiratory Therapy and AsthmaRespiratory Therapists can follow Asthmatics in all places,situations and scenarios which include:-Hospital ER’s-ICU’s-Clinics-Breathmobiles-Health Fairs.
Respiratory Therapy and AsthmaPreventative CareCritical Care
Respiratory Therapy Responsibilitieswith AsthmaPreventative CareAsthma EducationSelf ManagementCritical CareBreathing TreatmentsSpirometry andPulmonary Function TestsAirway and Blood GasManagementMDI and EquipmentTeachingVentilatorManagement
EPR 3
What is EPR 3?“The EPR 3 Guidelines on Asthma wasdeveloped by an expert panel commissioned bythe National Asthma Education and PreventionProgram (NAEPP) Coordinating Committee (CC),coordinated by the National Heart, Lung, andBlood Institute (NHLBI) of the National Institutesof Health.”
EPR 3440 pagesIntroductionAcknowledgements and Financial DisclosuresAcronyms and AbbreviationsPrefaceFive Sections
Four Components of AsthmaManagement1. Measures of assessment and monitoring,obtained by objective tests, physicalexamination, patient history and patient report,to diagnose and assess the characteristics andseverity of asthma and to monitor whetherasthma control is achieved and maintained2. Education for a partnership in asthma care3. Control of environmental factors and comorbidconditions that affect asthma4. Pharmacologic therapy
Component #1Measures of assessment and monitoring, obtainedby objective tests, physical examination, patienthistory and patient report, to diagnose and assessthe characteristics and severity of asthma and tomonitor whether asthma control is achieved andmaintained SCREENING
Goals of Asthma ScreeningsCollect Data for a Diagnosisand PlanTeach Patients to SelfManage AsthmaTo follow up on Adherenceof Diagnosis and Plan
Asthma Management Starts with aScreening.Common Asthma CycleAsthma Care CycleExacerbationScreeningHomeERTreat emandStreet emFollow UpDiagnosisPlan
What is an AsthmaScreening? Whatinformation is collected? History andQuestionnaires PhysicalAssessmentandMeasurements
QuestionnairesMedicalHistory andInformationSocioEconomicHistory andInformationEnvironmentalHistory andInformation
Medical History and QuestionnairesSeverityandControl Frequency of SymptomsNight time AwakeningsSABA use (Albuterol)Interference with normal activityLung Function ResultsExacerbation requiring oralCorticosteroids ATAQ, ACT, ACQ ValidatedQuestionnaires
Physical Assessment andMeasurements VitalsBreath Sounds (wheezing)Breathing patternSpirometryExhaled Nitric OxideAllergy and Blood testsMDI Evaluation
Asthma is an Obstructive Disease andLimits Exhalation
SpirometryIs a Pulmonary Function Test (PFT), thatmeasures lung function, specifically theamount (volume) and/or speed (flow) ofair that can be inhaled and exhaled.(Flow-Volume Loop.)“Gold Standard of AsthmaDiagnosis”
Spirometry
Flow Volume Loop FVC: The volume change of thelung between a full inspiration tototal lung capacity and a maximalexpiration to residual volume. PEF : Peak Expiratory Flow is themaximum flow generated duringexpiration performed withmaximal force. FEV1: The FEV1 is the volumeexhaled during the first second ofa forced expiratory maneuver. FEF 25-75% : Forced ExpiratoryFlow of FEV1. Mid ExpiratoryFlow FEV1%/FVC: is the standard indexfor assessing airflow obstruction.
Flow-Volume LoopsNormalNormal Vs Asthmatic
Pre and Post Spirometry
Spirometry and AsthmaA patient with reactive airway disease orAsthma will have at least a 12% or 200 mlincrease in FEV1 between the Pre and PostSpirometry tests.
Asthma Screening is collecting thepieces of the Asthma Puzzle
Completed ScreeningsCompletedQuestionnairesCompleted PhysicalAssessmentCompletedPulmonary FunctionTests
EPR 3 Asthma ManagementDiagnose AsthmaAssess SeverityInitiate Medication and Demonstrate UseDevelop Written Asthma Action PlanSchedule Follow up appointment
Asthma Plan Adherence“In 2008 less than half of people with asthmareported being taught how to avoid triggers.Almost half (48%) of adults who were taughthow to avoid triggers did not follow most of thisadvice.”CDC Vital signs, Asthma In the US. May 2011
Where to get Asthma Screenings?BreathmobilesPhysician Offices
Where to get Asthma Screenings?
Screening ObstaclesInsuranceReimbursementsTimeSchool and WorkTransportation and LocationReferrals
Asthma ReviewAsthma is a Chronic Disease.Asthma Needs to be Managed.Asthma Management Starts with Asthma Screenings.
Tim StromRCPRRT-NPSAE-C
Medical History and Information. SocioEconomic History and Information. Environmental History and . Frequency of Symptoms Night time Awakenings SABA use (Albuterol) Interference with normal activity Lung Function Results Exacerbation requiring oral Corticosteroids ATAQ, ACT, ACQ Validated . Asthma Review. Asthma .
