The doctor will also consider whether other health problems, such as sinusitis, may be interfering with asthma control. And finally, efforts at avoiding environmental triggers must be looked at. When a child continues to come into daily contact with triggers, asthma control will be challenged. It should be emphasized too that every child should have a written, personalized Asthma Action Plan that guides parents on a day to day basis with managing their child's asthma.
When stepping up treatment, or addressing the other factors discussed above, doesn't improve the child's health status, then a referral to an asthma specialty doctor is strongly encouraged, particularly in the presence of any of the following conditions:
- Control is difficult to achieve.
- A child in the 0 to 4 years age group requires step 3 or higher care.
- A child in the 5 to 11 years age group required step 4 or higher care.
- The child has an asthma flare that requires hospitalization.
- Allergy tests or allergy shots are to be considered, due to suspicions of allergic factors.
Physician Follow-up Care for Kids With Asthma
Once control has been achieved, the Expert Panel still recommends that kids be seen by their doctors every 1 to 6 months. If a future step-down in treatment is planned, then the child should be seen at 3-month intervals until this occurs. Step-down should be considered if a child has been under control for at least 3 months.
Source:
"Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma." NHLBI Guidelines for the Diagnosis and Treatment of Asthma. 28 Aug 2007. National Heart Lung and Blood Institute. 18 Dec. 2007 <http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf>
