To minimize asthma flares it is important to identify one's
triggers and to take appropriate measures to avoid or minimize
exposure to the triggers. Asthma triggers may include allergies,
inhalants such as smoke or perfumes, dust, weather changes, air
pollution, exercise, infections, food allergies, and stress.
Identify the patient's triggers and make appropriate
recommendations to avoid or minimize their exposure. The
is the 'All Clear' zone. The patient should not be
- daytime or nighttime symptoms,
- should be able to perform usual activities,
- should have infrequent use of quick reliever-rescue
- have peak flows of 80% of their personal best or better.
A quick reliever-rescue medication, such as albuterol or
levalbuterol, should be available for breakthrough symptoms. A
quick reliever medication may also be appropriate for use prior to
exercise for individuals with exercise-induced asthma.
Long term controller medications are required for patients
classified as having mild, moderate or severe persistent asthma.
Refer to the NAEPP Expert Panel Report Guidelines for the
Diagnosis and Management of Asthma (pages 4 &
5) for additional information. Recommendations for long
term controller medications and appropriate doses are based on age
according to these standards.
These guidelines do not establish a standard of care to be followed in every case. It is recognized that each case is different and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time.
It is impossible to anticipate all possible situations that may exist and to prepare guidelines for each. Accordingly these guidelines should guide care with the understanding that departures from them may be required at times.