Treatment Strategy: Severe Childhood Asthma
Treatment Strategy: Severe Childhood Asthma

Treatment Strategy: Severe Childhood Asthma

Alternate day therapy should be attempted for patients who require maintenance therapy due to severe disease.The National Asthma Education Program ReportThe National Heart,Guest Posting Lung, and Blood Institute (NHLB) and its National Asthma Education Program (NAEP) convened a panel of experts on the management of asthma who released a comprehensive report (“Guide-lines for the Diagnosis and Management of Asthma”) in 1991. This excellent resource included a suggestion for a “traffic light system” that would allow patients to easily remember how to manage their asthma. This green-yellow-red zone system has been adopted by many physicians and has been included in at least one peak flow meter design.   Tiny Zone

The Green ZoneAs defined by the NAEP the green zone is a safe area in which the asthma patient experiences few or no symptoms. Peak flow measurements are 80 to 100 percent of a patient’s predicted normal value or personal best with no more than a 20 percent swing in values. Medications are individualized for each patient, whether they are mild, moderate, or severe asthmatics.The Yellow ZoneThe yellow zone outlined by the NAEP signals “caution.” The patient has peak flows that are 50 to 80 percent of his or her predicted normal or personal best and/or asthma symptoms that may include nocturnal attacks, coughing, wheezing, decreased activity, and chest tightness. This “zone” indicates that medications should be adjusted according to the management plan suggested by the physician. Patients who make frequent visits to the yellow zone should have their maintenance medications reviewed and adjusted.

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