Managing asthma to give you freedom to enjoy life
Living with asthma means juggling all the factors that can make you or your child feel better or worse, or trigger an attack. Weather, exercise and even food can all impact asthma conditions. However, taking your asthma medication correctly, and following your treatment plan, can help you better manage day-to-day triggers and keep your asthma in control.
Asthma management products can help:
Reduce chronic asthma symptoms
Stay on track with your long-term treatment plan
Respond to triggers around you
Are you in control of your asthma?
If you think your or your child’s asthma is in control, you are in good company. Most people living with asthma believe they have their asthma under control, but studies have found that fewer than half of them actually do 1.
on effective asthma management and the tools you can use to improve the quality of life for you or your child. Read more
Less than 1 in every 5 Australians with asthma aged over 15 years have a written asthma action plan 2.
90% of patients have incorrect MDI technique 3.
66% of individuals were identified with low adherence to prescribed medication 4.
Nearly 1 in 3 adults miss at least 1 day of work each year because of their asthma 5.
Nearly 1 in 2 children miss at least 1 day of school each year because of their asthma 5.
Are you caring for a child with asthma?
Making sure your child is staying on track with his or her asthma treatment can be scary and stressful. Using medication delivery devices like an inhaler spacer or nebuliser can help your child get their medication to their lungs where it works and give you more peace of mind.
Breathing treatment wherever you are
Managing asthma can take commitment, but it doesn't have to tie you down or disrupt the daily routines of your life. There is a range of breathing treatments or nebulisers that gives you the flexibility to treat and manage your asthma at home, at school, or on the go. You can always choose the device that matches your lifestyle and routine!
Breathing treatment at home
Portable breathing treatment Ask your healthcare professional or pharmacist about asthma management
Your healthcare professional or pharmacist can be a valuable resource for understanding the use and benefit of including asthma management devices as part of a treatment plan.
Frequently asked questions
What are the Asthma controller (preventer) medications and how do they work? What are the Asthma controller (preventer) medications and how do they work?
Controller medications may also be called preventers. These are medications that are prescribed by your healthcare professional to take daily to control the inflammation (swelling) in your lungs and to prevent asthma attacks. There are several different types of controller medications but the most common are inhaled corticosteroids (steroids) or combination inhaled steroid and long-acting bronchodilators. Long-acting bronchodilators are not prescribed alone for asthma but may be prescribed with an inhaled steroid. This is a medication to keep airways open over a long period of time. Controller medications and combination controller medications should not be used to relieve symptoms during an asthma attack.
References: asthma.org.uk Advice/inhalers-medicines-treatments. Accessed October 2017 What are the Asthma reliever (rescue) medications and how do they work? What are the Asthma reliever (rescue) medications and how do they work?
Reliever medications are short-acting bronchodilators. They may also be called rescue medications. These are medications that act very quickly to relax the muscles surrounding tightened airways and relieve asthma symptoms.
References: asthma.org.uk Advice/inhalers-medicines-treatments. Accessed October 2017 Are you worried that your child's controller medication is not helping? Are you worried that your child's controller medication is not helping?
Controller medications work differently than reliever medications and must be taken even when symptoms may not be present. The controller medications reduce inflammation but they take time to start working. Your child may need to take them for several days or weeks before you and your child notice an improvement. Your child will not feel that immediate relief that they may feel after taking a reliever medication. Instead they will know that they are working because over time, they will have less symptoms and they will need to use their reliever medication less.
References: asthma.org.uk Advice/inhalers-medicines-treatments/inhalers-and-spacers/preventer. Accessed October 2017. What will happen if my child doesn't take their controller medication? What will happen if my child doesn't take their controller medication?
If the inflammation in asthma is not controlled, it will be difficult to manage your child's asthma symptoms. Also over time the inflammation may permanently damage your child's airways.
References: webmd.com Asthma/features/preventing-permanent-damage#1. Accessed October 2017 What are the possible side effects of inhaled steroids? What are the possible side effects of inhaled steroids?
If your child uses their inhaler correctly, they are less likely to have side effects. This is because more of the inhaled medicine goes down to the lung where it’s needed. If your child uses inhaled steroids, which is a type of contoller medication, some of the side effects that may occur due to poor inhaler technique include:
a sore tongue a sore throat a mouth infection called thrush
These side effects could easily be prevented by rinsing their mouth after inhaling the medication and using a spacer or valved holding chamber when using a metered dose inhaler (MDI).
References: asthma.org.uk Advice/inhalers-medicines-treatments. Accessed October 2017. Can I stop giving my child's controllers medication if she/he shows no asthma symptoms for some time? Can I stop giving my child's controllers medication if she/he shows no asthma symptoms for some time?
Remember that your child’s asthma changes over time, and some degree of inflammation or swelling is usually present, even when they are not having any symptoms. Generally, the benefit of the treatment is much greater than any risk associated with taking the medication, even in periods where your child seems to be ok. You should not stop your child's inhaled steroid (controller medication) unless you have discussed this with the healthcare professional first.
References: asthma.org.uk Advice/inhalers-medicines-treatments. Accessed October 2017. How long does my child have to take a controller medication before it starts working? How long does my child have to take a controller medication before it starts working?
It may take several days or a couple of weeks before the medications are effective. Your child may not feel different at the very beginning, but they need to take it every day so its protective effects can build up. Your child should not stop taking it unless you have discussed this with the healthcare professional.
References: asthma.org.uk Advice/inhalers-medicines-treatments. Accessed October 2017. How can I be sure I am getting the medication from my inhaler down into my lungs? How can I be sure I am getting the medication from my inhaler down into my lungs?
When you press down on the top of your inhaler, it creates an aerosol mist traveling very fast. Because the medication mist is moving quickly, timing is important. This means that you should start breathing before you press down on the inhaler and breath in slowly and deeply. Therefore, it is important that you use your inhaler perfectly. Both spacers and Valved Holding Chambers (VHC's) are devices that may be used to overcome these timing issues and help you get more medication where you need it. These are simple devices that attach to your inhaler. When you push down on the inhaler, the mist is dispensed into the device where it is held temporarily until you inhale. This gives you the time to breathe in the medication slowly and deeply into your lungs.
What is an Asthma Action Plan? What is an Asthma Action Plan?
An asthma action plan (also known as a treatment plan) is a plan for managing your child's asthma. The goal of this plan is to reduce symptoms, prevent serious asthma flare-ups and emergency trips to the hospital. The plan includes written instructions so you and your child can:
identify early symptoms of an asthma flare-up and treat them with the proper medication to prevent them from getting worse know how to use the medications to manage a full-blown flare-up know when to call the doctor or seek emergency care
Make sure to bring the asthma action plan on each doctor visit to review and update as necessary. If your child doesn’t have a personal asthma action plan yet, make an appointment with their doctor to create one.
References: asthma.org.uk. Advice/manage-your-asthma/action-plan. Accessed October 2017 Know your child’s Asthma Action Plan – Green Zone Know your child’s Asthma Action Plan – Green Zone
A personalised asthma action plan is a written plan designed by you and your doctor that provides instructions on how to control your or your child's asthma. Because everyone's asthma symptoms and triggers may be different, the action plan should be personalised or customised to the individuals asthma. Contact your doctor and set up an appoitnment to develop an asthma action plan.
The green zone in your child's asthma action plan shows what they should be doing when things are going well to prevent asthma symptoms.
The Green Zone means: Breathing is good No cough, wheeze, chest tightness or shortness of breath Sleeping through the night without symptoms Can play and participate in sports Peak flow above 80% of personal best
References: mayoclinic.org. Diseases-conditions/asthma/in-depth/asthma/art-20044888. Accessed October 2017. Know your child’s Asthma Action Plan – Yellow Zone Know your child’s Asthma Action Plan – Yellow Zone
The yellow zone in your child's asthma action plan shows what they should be doing when they start to have symptoms or are exposed to a trigger that is likely to cause symptoms.
The Yellow Zone means: First sign of cold symptoms Exposure to known triggers Peak flow between 50% and 80% of personal best Symptoms may include:
- Some wheezing
- Tight chest or shortness of breath
- Coughing at night or wakening at night with asthma symptoms
- Decreased ability to play or do usual activities
References: aafa.org Page/asthma-treatment-action-plan. Accessed October 2017. Know your child’s Asthma Action Plan – Red Zone Know your child’s Asthma Action Plan – Red Zone
The red zone in your child's asthma action plan shows what they should be doing when they have an asthma medical alert. Urgent action is necessary if you child is in the Red Zone.
Red Zone means: Wheezing, coughing and shortness of become worse after giving yellow zone medicine. Shortness of breath while walking, talking or resting. Use of chest muscles while breathing. Wheezing may be absent if symptoms are very severe. Child is unable to sleep or do usual activities or play because of trouble breathing. Peak flow below 50% of personal best
References: aafa.org Page/asthma-treatment-action-plan. Accessed October 2017. How to perform a peak flow measurement using the Philips PersonalBest peak flow meter. How to perform a peak flow measurement using the Philips PersonalBest peak flow meter.
The peak flow meter is a simple, hand-held device which is used for measuring your child's peak flow value.
Guide your child to measure their peak flow value with a peak flow meter by following these steps: Slide off the top cover and unfold the bottom cover into a handle. Move the red indicator to the bottom of the scale. Stand up, if possible. Instruct your child to breathe in as deeply as they can, and put their lips and teeth around the mouthpiece. Blow out as hard and fast as they can, staying straight. They should not bend over as they blow. Read the peak flow measurement next to the indicator, and see what color-coded section their reading is in (if their peak flow zones have been established). Write down the reading. Then slide the indicator back down to the bottom of the scale. Repeat steps 4 and 5 two more times and write down the reading each time. Then, the highest reading from three attempts should be recorded as your children's peak flow reading. It's a good idea to let your children practice using the peak flow meter in front of their healthcare professional. Daily peak flow measurements Daily peak flow measurements
Daily peak flow monitoring using a diary or chart can help you to determine whether your child's asthma is stable or worsening. In conjunction with their prescribed asthma action plan, you can take appropriate action to bring your child's asthma back under control.
References: lung.org. Lung-health-and-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/measuring-your-peak-flow-rate. Accessed October 2017.
What should I consider when selecting a spacer or valved holding chamber? What should I consider when selecting a spacer or valved holding chamber?
Look for an enhanced type of spacer that has a valve - this is called a valved holding chamber. This chamber has a one way valve that only opens during inspiration which prevents you from exhaling or pushing the drug out of the chamber. You should also select one that is made of anti-static material. This material keeps the mist in the air longer and the one way valve holds it for a short period of time in the chamber so you have the time to inhale into your lung. Ideally the chamber should also have an audible flow signal, which will alert you if you are breathing too fast.
References: lung.org. Lung-health-and-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/valved-holding-chambers. Accessed October 2017 What should I consider when selecting a facemask? What should I consider when selecting a facemask?
Babies and all young children who cannot use the mouthpiece of the spacer should be encouraged to use a facemask. It is important that the facemask fits comfortably on the face providing a good fit, to help them receive the proper dose of inhaler medication 1.
References:  Erzinger, S. et al. Facemaks and aerosol delivery in vivo. Journal Aerosol Medicine 2007; 20 (Suppl 1):S78-S84  Tong, K. et al. An Instrumented Valved Holding Chamber with facemask to measure application forces and flow in young asthmatic children. Journal of Aerosol Med and Pulm Drug Del. 2014; 27 (Suppl 1): S55-62. I use a spacer with mask for delivery of inhaled medication to my child. How do I know when they are breathing the medication in from the spacer? I use a spacer with mask for delivery of inhaled medication to my child. How do I know when they are breathing the medication in from the spacer?
Make suire you are using a spacer or valved holding chamber that has some type of indicator that you can monitor when your child is breathing in(1), such as a whistle. Some spacers also allow you to visualise when your child is breathing out with an exhalation valve. This allows you to time the release of the medication when the valve closes. You can also count the number of breaths they hake from the chamber.
References:  lung.org Lung-health-and-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/valved-holding-chambers. Accessed October 2017 My two year old fights me when I try to use a mask to give them a puffer. What can I do to make treatment time less of a struggle? My two year old fights me when I try to use a mask to give them a puffer. What can I do to make treatment time less of a struggle?
Children up to 3 years of age cannot use a mouthpiece, so treatment with a spacer should be given with a face mask 1. Leaks around the face mask can result in decrease medication being inhaled 3. To prevent leaks, you may need to hold the face mask on your child's face tightly. This causes the child to cry and fuss during the treatment. Crying causes more of their medication to be inhaled into the stomach and less in the lungs where it is needed. Philips LiteTouch ensure you select a mask with a good seal. Masks with soft silicone cushions tend to be more comfortable than conventional VHC masks(2) also select a low volume chamber (less than 350ml). The larger chambers require more breaths and more time to get all the medication from a single dose(4). This combination of soft, comfortable mask, and small volume chamber may hel you deliver the medication quickly and comfortably to your child.
References:  Global Initiative for Asthma(GINA). Global strategy for asthma management and prevention. ginasthma.org updated Dec 2010. Accessed 13 January 2016.
 Tong, K. et al. An Instrumented Valved Holding Chamber with facemask to measure application forces and flow in young asthmatic children. Journal of Aerosol Med and Pulm Drug Del. 2014; 27 (Suppl 1): S55-62.  Erzinger, S. et al. Facemasks and aerosol delivery in vivo. Journal Aerosol Medicine 2007; 20 (Suppl 1):S78-S84  Nikander, K. The evolution of spacers and Valved Holding Chambers. Journal of Aerosol Med and Pulm Drug Del. 2014; 27 (Suppl 1): S4-24. How can I objectively monitor my child’s asthma? How can I objectively monitor my child’s asthma?
From age 5+ Monitoring your child’s peak flow readings with a peak flow meter and tracking them with a diary or chart can help you to objectively determine whether your child's asthma is stable or worsening. In conjunction with their prescribed asthma action plan, you can take appropriate action to bring your child's asthma back under control.
References: lung.org Lung-health-and-diseases/lung-disease-lookup/asthma/living-with-asthma/managing-asthma/assess-and-monitor-your. Accessed October 2017 What is the peak flow meter and how does it work? What is the peak flow meter and how does it work?
A peak flow meter is a small handheld device that is best suited to be used in children 5 years of age or older. It is used to measure the "peak expiratory flow (PEF)" of your child. PEF is a measurement of how fast your child can blow air out of their lungs after they take a full breath. When they blow into the mouthpiece the small marker will move, and where it ends up is the peak flow reading. The highest reading from three attempts should be recorded as their peak flow reading. If your child's asthma is well controlled, their airways are open, so they are able to blow air out of the lungs quickly, which will give a high peak flow reading. However, if your children's asthma is not controlled, the airways will narrow and they will not be able to blow air out so fast, which will give a lower peak flow reading.
References: Asthma.org.uk. All_about_asthma/controlling_your_asthma/resources_to_help_you/peak_flow_diary. Accessed Oct 2017. What is personal best peak flow reading? What is personal best peak flow reading?
Your children's personal best peak flow reading is the highest reading that they can achieve when their asthma is well controlled. Well controlled means that they are feeling good and having no symptoms. To determine personal best peak flow, record the highest peak flow reading from three attempts that are performed twice a day for 2 weeks. Personal best peak flow is the highest reading achieved over this two week period. Remember that keeping track of your child’s peak flow reading is an important step in managing their asthma symptoms and preventing asthma flare-ups. All this information is recorded in a diary used by your healthcare professional.
References: Webmd.com. Asthma/guide/peak-flow-meter. Accessed October 2017.
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DISCLAIMER: Information on this website is informational only and should not replace the advice of a physician.
ALWAYS FOLLOW THE DIRECTIONS FOR USE.
 gsk.com. Media/620439/the state-of-uncontrolled-asthma-in-america-infographic.pdf. Accessed October 2017.
 Australian Government Productivity Commission (AGPC) 2018, Report on Government Services
 Bidwal M, Lor K, Yu J, IpE. Evaluation of asthma medication adherence rates and strategies to improve adherence in the underserved population at a federally qualified health center. Res Social Adm Pharm. 2017, 13(4): 759-766.
 Bonds R.S. Misuse of medical devices among patients in a tertiary care Allergy/Immunology practice. Journal of Allergy and Clinical Immunology, 2017, 133(3) supplement: AB156.  CDC National Asthma Control Program. Asthma’s Impact on the Nation. Accessed December 2016.
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