[Round Table: Severe asthma in pediatrics: prevention]

1. Evaluation of individual propensity to severe asthma using risk factors. 2. Regular follow-up at intervals of 3-4 months, regardless of the patient's stability in a given moment. 3. Measurements of pulmonary function at each visit and at home daily (PEF). 4. Monitoring evolution in relation to the need for specialist consultations and psychological care. 5. Factors influencing propensity to death should be treated specifically. 6. Designation of a person outside the family responsible for the patient's care. 7. Use of community resources. 8. Monitoring personal/family compliance with treatment programs. 9. Informing the patient and family about the patient's tendency to severe asthma. 10. Developing an emergency plan for facilitating communication when asthma becomes unstable. The plan should emphasize eliminating any delay in obtaining care during an attack. The plan should include: a) A list of preventive medications with dosing guidelines. The simplest possible regimens should be established. b) Criteria for using rescue medication and emergency care in each specific case. c) When the physician should be called in and what to do when the physician cannot be contacted. d) An exact description of the signs and symptoms that indicate that the patient should visit the emergency room without delay. Advance designation of the emergency service to be used. e) Suitable vacation planning. 11. Mechanisms guaranteeing fluid and effective communication between the unit and patients with severe asthma. a) Programs for physicians, nurses and receptionists who take calls to establish measures for recognizing, identifying risk factors, and preventing complications in patients with severe asthma. b) Compilation of a list of patients with severe asthma. c) Patients with severe asthma should be identified by a medical alert card. d) Calls from patients with severe asthma should be taken immediately.