The basics of these guidelines is that your doctors should use a stepwise approach to managing asthma depending on how severe a child's symptoms are classified. For improving symptoms, a step down, or decrease in regular medications should be made. And there should be a step up for worsening or poorly controlled symptoms until the following goals are met:
- Minimal or no chronic symptoms during the day or night.
- Minimal or no exacerbations.
- No limitations on activities; no school/work/parent's work missed.
- Peak flows (for older children that are able to do peak flows) greater than 80% of personal best.
- Minimal use of inhaled short acting beta2-agonists (less than once per day, less than one canister a month).
- Minimal or no adverse effects from medications.
How do you classify your child's asthma? According to the guidelines, your child's asthma can be classified as:
- Mild Intermittent: Symptoms less than or equal to 2 days a week or 2 nights a month. Peak flows greater than or equal to 80% of your child's personal best, with less than 20% variability in daily peak flow measurements.
- Mild Persistent: Symptoms more than 2 days a week, but less than once every day or more than 2 nights a month. Peak flows greater than or equal to 80% of your child's personal best, with less than 20-30% variability in daily peak flow measurements.
- Moderate Persistent: Daily symptoms or symptoms more than 1 night a week. Peak flows that are 60 to 80% of your child's personal best, or more than 30% variability in daily peak flow measurements.
- Severe Persistent: Continual daytime symptoms and frequent symptoms at night. Peak flows that are less than or equal to 60% of your child's personal best, or more than 30% variability in daily peak flow measurements.
