De De’s Tips

• We need to know the patient has asthma and has been diagnosed.
• We need to know the patient with asthma and those with allergies have been tested using skin testing to determine what the allergens are for that individual.
• Once we know what the allergens are or the triggers are we can devise a trigger avoidance plan.
• The key is self-management: teaching patients to recognize when they have been exposed to a trigger and they need to recognize their “early warning signs” of asthma. This could be itchy throat, watering eyes or nose, coughing or sneezing.
• If you teach the patient to use the Asthma Action Plan (AAP), then use the TEACH BACK method or ECHO method to have the patient teach you how to use the AAP.
  For example, give the patient the following scenario:

   

  • If I were using a peak flow meter and the value was in the yellow zone; what should I do?
  • Then have the patient teach you what to do and when you learn the patient has a hole to fill; then reteach the patient about the zone and what to do.
  • You can use the phrase: “I have done a bunch of talking; could you tell me what you will say to your parents; wife; friend when you get home about the AAP?”
• In order to self-manage asthma or allergies, the patient must pick up the medication and then must know the following:
  • What medication is prescribed;
  • When to take the medicine;
  • How often to take the medicine;
  • How to use the delivery device and
  • What to do if this is not working.

Use the TEACH BACK or ECHO method to confirm your patient understands these expectations.

• Be mindful of outdoor air quality action days: recognize the signs and symptoms related to issues associated with poor air quality.
  • I would also recommend the patient or parent of patient watch for the news stations that report the “Air Quality Index” (AQI). This reports the combined amount of particulate matter and ozone letting us know how clean or polluted our air is as it relates to our health.