The second step is called environmental control. There are many things in our environment that are known to make asthma worse. Every effort must be given to reducing the potential "allergic burden" in the household, particularly in the child's room. There are many resources available at your doctor's office and on the Internet that discuss how to "dust proof" a room.
Dust: Many asthma patients are allergic to dust, and removing its sources is very important. These include stuffed animals, heavy drapes, plants and heavy carpets, all of which collect dust. Dust proof covers can be obtained for mattresses and pillows. Bedding should be washed in hot water weekly to kill dust mites. There are chemical carpet treatments to control mites if removal is not an option. Special filters can be placed on forced air heating systems.
Additional triggers: In addition, exposure to toxins must be minimized. Most importantly, no one is allowed to smoke in the house and preferably not at all, since smoke on clothing can be enough to cause symptoms in a sensitive child. Also, pets are not a good idea for the child with asthma, particularly cats which are very "asthmagenic". Chemical fumes from perfumes and paints should be minimized. There are also steps to reduce mold in the household. If you can reduce the allergens in the house, it is less likely that other irritants, such as viral infections, will actually trigger an attack.
Teaching parents how to monitor the severity of symptoms is the third step in asthma control. This is only useful for children able to cooperate with the use of a peak flow meter. This is a device that measures how much air your child can blow out when he tries his hardest. The peak flow meter gives you a number that indicates how obstructed the airflow is, and therefore how severe the asthma is at that moment. A child must be at least 5 years old to use a peak flow meter. There are known "normals" for children based on their height, and these numbers can be obtained from your pediatrician. Knowing your child's peak flow value can be very helpful in answering questions like: "How sick is she?" and, "How did she do when we changed her medicine?"
Lastly, there is the matter of proper equipment. Not only must you have the equipment, you must take it out of the closet and use it. We already mentioned the invaluable peak flow meter. There are 2 other devices that are usually necessary: a spacing chamber for the inhaler, and a nebulizer
Spacing chamber: Many asthma medicines come in the form of inhalers (although better devices will be available in the next year or so). Children are not very adept with inhalers. Much of the medicine is lost in the air and is not actually inhaled into the lungs. Everyone (including adult asthmatics) should use a spacing chamber with their inhalers. This is a tube with a one-way valve into which you put the inhaler. The inhaler is then puffed into the tube, which has a mouthpiece or mask at the other end. The child breathes the contents of the tube after the puff. Studies have shown that this device vastly increases the amount of medicine that actually gets into the lungs, where it needs to go to do its work.
Nebulizer: Another useful device is called a nebulizer. This is a compressed air generator that makes a 'mist' of the medicines. Studies have shown that delivering medicine with this device is most effective in getting the medicine where it needs to be: the lungs. This is the device that is used in most doctor's offices and emergency rooms.
Medicines For Asthma
The following is a brief outline of the various types of medications that can be used to treat childhood asthma.