5 things you must tell asthma patients

Offer verbal and written information

Does every asthma patient leave your ED with a better understanding of how to control future exacerbations? "Patients should leave the ED with both verbal and written instructions," according to Karen Huss, RN, DNSc, CANP, FAAN, associate professor at Johns Hopkins University School of Nursing in Baltimore. "Asthma has a high morbidity and a significant mortality rate, so asthma control is very important," she adds. Huss recommends addressing the following things when you educate asthma patients:

1. Demonstrate use of inhalers.

Have a hands-on demonstration, Huss suggests. "Having placebo inhalers with cardboard mouthpieces you can put over the delivery end to keep them clean helps," she adds. "The educator should demonstrate, then watch the patient as they do it."

2. Give patients a steroid schedule.

Asthma patients often lack understanding about the course of steroids they are given when they leave the ED. "Often, there is so much information on the prescription label that they become confused," Huss says. "They may not take the steroid at all because they are not educated in how to take it and how it will help." Huss recommends giving every patient a steroid schedule. "This is like a calendar with every day in a little box," she says. "The number of prednisone tablets they are expected to take daily is written in red."

3. Explain how to use peak flow meters.

For monitoring asthma, ED staff can introduce patients to peak flow meters in the ED, Huss suggests. "After proper instruction in their use, patients could keep a record of their peak flow at least once a day until the time they see a specialist for follow-up," she adds.

4. Educate patients about use of spacers.

Children benefit from the use of spacers, which make it easier for them to correctly inhale the medication, says Lisa Molitor, MSN, ARNP, CEN, CCRN, ED nurse practitioner at Shands at Alachua General Hospital in Gainesville, FL. "Very small children and babies usually do better with a passive nebulizer machine."

5. Address types of medications.

Huss emphasizes the appropriate use of long-term controllers that the patients should take every day and the quick relief medications that they take only as needed. "It is very important that patients understand the difference," she stresses.

Sources

For more information about educating asthma patients in the ED, contact:

Karen Huss, RN, DNSc, CANP, FAAN, Johns Hopkins University, School of Nursing, 525 N. Wolfe St., Room 416, Baltimore, MD 21205. Telephone: (410) 614-5296. Fax: (410) 955-7463. E-mail: khuss@son.jhmi.edu.

Lisa Molitor, ARNP, RNC, MSN, CEN, CCRN, 8404 S.W. 28th Place, Gainesville, FL 32607. E-mail: Lmolitorge@aol.com.