My asthma Care Plan

Care Plan Instructions:
( updated 8-1 -2010)

1)Monitor peak flows 4 times a day and/or whenever feeling short of breath.

2)If dipping into yellow zone for more than 24 hours, bolus with 60 mg prednisone, increase neb treatments accordingly.

3)If remaining in yellow zone for more than 24 hours after taking prednisone….go to ER.

4)If dipping into red zone, even briefly,….. Don’t wait , go directly to ER!

5)If experiencing rapid chest tightness, inspiratory wheezing, or rapid drop in peak flows or FEV1s….. go directly to ER.

6)Regardless of the other steps, if requiring neb treatments more often than every 2 hours, go directly to ER.

Since I’m what they call a “poor perceiver” ( meaning I don’t always sense when my breathing is getting bad), it’s important that I use objective data when assessing my symptoms, ie..PFs, FEV1s, breath sounds, O2 sats, etc. Because I don’t have much lung reserve, and because I tend to decompensate rather quickly when a severe exacerbation is underway, it’s generally better for me to seek hospital treatment sooner, rather than later. I admit though, that I’m not very compliant with this rule.

Finally, while a solid asthma action plan is a must for any asthmatic, choosing the right hospital and or/doctors to manage your asthma if you get sick, is especially important if you have severe chronic asthma. While severe persistent asthma isn’t extremely rare ( about 5% of asthmatics), finding a doctor who truly understands the more severe form of this disease certainly is. It’s essential that you develop a good relationship with an experienced Pulmonologist BEFORE you get sick.

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Most frequently asked question

"Can you have an asthma attack with a normal sat reading"?
The answer is..YES!
While it's a little unusual to see a person with a perfect O2 sat of a 100% during a severe exacerbation, its pretty typical to see sats in the 94-97% range. The reason for this, is that asthma is a disease of the airways , not the alveoli where gas exchange takes place. Most asthmatics dont desaturate during the early stages of an attack,unless theres a secondary problem such as pneumonia. You have to be extremely ill with asthma if your sats are low.

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