* There are also specific action plans available for
Click on the task for more detail or on the resource to obtain appropriate material
Review need for preventative
treatment
- Consider preventative treatment if
- Wheezing attacks less than 6 weeks apart
- Attacks becoming more frequent and severe
- Increasing interval symptoms
Options for initial
preventative treatment
- frequent episodic asthma - cromoglycate, nedocromil, inhaled steroids
- persistent asthma - inhaled steroids
Check inhaler technique
Emergency attendance or admission should provide the patient and family with the opportunity to use a spacer device and pMDI
Make sure the child and family can use the device adequately and know the importance of using it for all preventative therapy and treatment for significant exacerbations.
Family education
On discharge from the Emergency Department or ward it is important that families understand theimmediate management of their child's asthma and care of spacers etc.It is not appropriate to educate them on all aspects of asthma during an acute episode. This
is best reserved for a visit to an outpatient clinic or doctors rooms at a time remote from the acute episode when a reasonable amount of time can be allocated and it is more likely that the information will be understood and retained.
Go over the action plan and give the brief parent handout.
Prescription
A prescription for all medications should be provided at the time of discharge. PBS scripts should be given to enable the patient to obtain their medication from any pharmacy.
Follow up
All patients should have a clear follow-up plan.
For some it will be appropriate that they visit their GP for an early review, particularly if their condition deteriorates or fails to improve significantly with 48 hours.
At discharge all patients should have an outpatient appointment or appropriate follow-up arranged with a paediatrician within 4-6 weeks. This visit will be used for medical review and, most importantly, appropriate education about asthma management.
Written action plan
All patients should have an individual written action plan and the discharging doctor should spend time going over the plan with the family.
A computerised plan may be generated by clicking here. Print 3 copies. One for family, one for the notes and one for GP
Communicate with GP
For every emergency attendance or discharge, their should be communication with the patients GP. If possible this should be by fax or telephone. The GP should receive a copy of the action plan.
Click here to compile a discharge letter. Print 2 copies. One for notes and one for GP
Other resources
Action plan generator
Asthma devices photoboard
Kids Health Info