Asthma Education Newsletter - Kids Health @ CHW

Welcome to the Winter Asthma Education Newsletter
for Parents and Carers. The Newsletter has been
developed by the Asthma Education Service at the
Children’s Hospital at Westmead (CHW) and is
designed for parents and carers of children with asthma
and contains up to date asthma information, medication
updates and management tips.
Patterns of Childhood Asthma
There are distinct patterns in childhood asthma that
determine the level of treatment required. The pattern of
childhood asthma is determined by the frequency of
episodes and the day-to-day symptoms, rather than the
severity of an acute episode.
The medication used to treat asthma in children is
determined by the pattern of your child’s asthma prior to
commencing regular treatment and the level of asthma
symptom control after commencing treatment. The
National Asthma Council (NAC) provides a useful
framework to help identify your child’s particular asthma
pattern.
Infrequent intermittent asthma
This is the most common pattern and accounts for 70%
to 75% of children with asthma. These children
experience isolated episodes of asthma, which can last
anywhere from one to two days up to one to two weeks,
usually triggered by an upper respiratory tract infection
(URTI) or environmental allergen. Episodes are usually
more than six to eight weeks apart and these children
are symptom-free in between episodes. The severity of
infrequent intermittent asthma varies. Episodes are
usually mild but children with this pattern account for
60% of paediatric hospital admissions. Children with
infrequent intermittent asthma are managed by using
inhaled bronchodilators, such as Ventolin or Asmol, as
needed. Regular preventive therapy is not
recommended for children with this pattern of asthma.
Frequent intermittent asthma
This pattern accounts for approximately 20% of children
with asthma. These children display a similar pattern to
infrequent intermittent asthma but the interval between
episodes is shorter, less than every six to eight weeks
and commonly occurring during the winter months.
These children may also experience minimal
symptoms, such as occasional night time cough or
Winter 2013
exercise induced wheeze. Children with frequent
intermittent asthma require inhaled bronchodilator as
needed and may benefit from regular preventive
therapy using non-steroidal preventers, such as Intal
Forte or Singulair, or low-dose inhaled corticosteroids,
such as Flixotide, Pulmicort, Qvar or Alvesco.
Persistent asthma
Approximately 5% of children with asthma have
persistent asthma. Children with persistent asthma
have acute asthma episodes but they also have
symptoms on most days in the interval periods. These
symptoms include sleep disturbance from wheezing or
coughing, early morning chest tightness and exercise
intolerance. Persistent asthma is further classified into
mild, moderate or severe, depending on the severity of
these symptoms. Children with mild persistent asthma
are treated with inhaled bronchodilators as needed and
regular preventer treatment with non-steroidal
preventers or low-dose inhaled corticosteroids. Children
with moderate to severe persistent asthma usually need
inhaled corticosteroids or combination therapy, such as
Seretide or Symbicort, or a combination of inhaled
corticosteroids and Singulair to control their symptoms.
Interval Asthma Symptoms
Interval asthma symptoms are regular asthma
symptoms that your child may experience between
episodes. Interval symptoms can develop during
particular times of the year, for example during autumn
and winter, and result in an increase in use of inhaled
bronchodilator.
Interval symptoms to look for include:
• Increasing night time wheeze, cough or shortness of
breath
• Sleep disturbance due to asthma
• Early morning chest tightness
• Change in activity patterns or intolerance to exercise
• Need for extra inhaled bronchodilator
•Increase in childcare or school absence due to asthma
If your child is experiencing any of the above
symptoms, it is important to arrange an appointment
with your child’s Paediatrician or GP for review of their
asthma management, as they may need ad adjustment
of their treatment or the use of preventer medication.
For further information on managing your child’s
asthma, visit www.asthmafoundation.org.au

Asthma Resource Pack for Parents &
Carers.
The Children’s Asthma Resource Pack for Parents and
Carers developed with Sydney Children’s and John
Hunter Children’s Hospital’s. In recent months work has
been undertaken and the resource pack is now
available in the following languages:
Arabic
Bengali
Nepalese
Chinese
Vietnamese
These resource packs can be viewed or downloaded:
http://kidshealth.chw.edu.au/fact-sheets
Smoking Cessation
Although you may have decided early in the New Year
to make changes to your lifestyle and stop smoking –
it’s never too late to start. Since July 2009 it is now
illegal to smoke in car whilst travelling with children.
You’re probably also getting cold and wet having to
smoke outdoors at work and home so now may be a
good time to consider kicking the smoking habit but you
may not know how to do this or who you can turn to for
assistance. You can seek support from your GP who
may review your medical history and will provide you
with information on the variety of methods of smoking
cessation, including options for using Nicotine
Replacement Therapy which are available in
Gum
Lozenges
Patches
Micro tabs
The Federal Government fund nicotine patches on the
Pharmaceutical Benefits Scheme (PBS). Smokers are
able to receive a four-week course of nicotine patches
for approximately $33.50 with a doctor's prescription.
Those holding a concession card can obtain a fourweek
course for $5.40 with a doctor's prescription. For
further advice on smoking cessation, information and
support, the following resources are available:
www.smokefreezone.org.au
www.health.nsw.gov.au
www.cancerinstitute.org.au
www.icanquit.com.au
Quitline is a free and confidential telephone support
service dedicated to helping smokers quit by assessing
your dependence to nicotine, providing strategies on
quitting and advice on the variety of methods available
to you to help you quit.
Tel: Quitline – 137848
Multilingual Quitline Numbers
Multilingual Information officers are trained and
accredited by Quitline NSW. Parents using this service
will have an initial consultation and receive advice.
Depending on individual needs, follow up calls to
monitor their progress may be offered. Multilingual
Quitline Numbers are:
Arabic 1300 7848 03 Italian 1300 7848 61
Chinese 1300 7848 36 Spanish 1300 7848 25
Greek 1300 7848 59 Vietnamese 1300 7848 65
Korean 1300 7848 23
After Hours Parent Group Asthma
Education ‘Open Airways’ Educational
Evening on Childhood Asthma
The Asthma Education Service will be offering four
group asthma education sessions this year for
parents/carer’s of children with a diagnosis of asthma.
Sessions are free and the focus is on childhood asthma
management.
Next Session on offer in 2013
Date: Wednesday 21 st August
Time: 6.30-8.30pm
Venue: The Children’s Hospital Westmead.
Your child must have a hospital Medical Record
Number and had a review by a Pediatrician or
Respiratory Specialist from CHW within the last 6
months. Bookings are essential and must be
received by the 26th July 2013
To register, or for further information please telephone
on the number listed below or via email to Lucy or
Tracey at lucy.hatton@health.nsw.gov.au
tracey.marshall@health.nsw.gov.au
For information on Asthma Education and Management contact Asthma Education Service Tracey Marshall
CNC Asthma Education: tracey.marshall@health.nsw.gov.au
Lucy Hatton CNS 2 Asthma Education: lucy.hatton@health.nsw.gov.au
Phone: 02 98452293 or via mail: Nursing Liaison Unit Locked Bag 4001, The Children’s Hospital at Westmead,
Westmead NSW 2145