Asthma Awareness
Mission Statement: The Asthma Awareness Education Program will address the needs of students and staff by creating asthma-friendly environments and by providing educational resources for the students and staff on asthma disease management. Program goals include increasing student/staff productivity and attendance; which benefit stakeholders with increased student performance, lower healthcare costs, and decreased absenteeism. Healthier children learn better.
4 Components to Achieve Asthma Control
Goal: Preventing Asthma Episodes and Controlling Your Asthma
For people with asthma, having an asthma management plan is the best way to prevent symptoms. An asthma management plan is something developed by you and your doctor to help you control your asthma, instead of your asthma controlling you. An effective plan should allow you to:
- Be active without having asthma symptoms. (Reliever inhaler use no more than twice per week for symptoms)
- Fully take part in desired exercise and sports – don’t settle for a sport with minimal exertion/running
- Sleep all night, without asthma symptoms. (Night-time cough no more than twice per month)
- Attend school or work regularly – normal school and work attendance as someone without asthma
- Have the clearest lungs possible. (Normal -or “near normal”- pulmonary function)
- Have few or no side effects from asthma medications. (Three or less quick reliever canisters refilled each year).
- Have no emergency visits or stays in the hospital.
- Asthma is a completely controllable disease. If you are not maintaining control, talk to your doctor.
Take the MY ASTHMA CONTROL ASSESSMENT from the American Lung Association
Rules of Two: When is quick relief for asthma NOT ENOUGH? link Do you....... if you answer yes to any, talk to your doctor
Component 1: Awareness
Asthma is the number one reason why students miss school days nationwide accounting for 14 million days annually. In NEISD this common health issue affects close to 8,000 of students (12% of population) and generates over 70,000 visits to the school nurse for use of asthma medications occurs each year.
Executive summary of report from ‘Children and Asthma in America' stated:
- Many children with asthma experience frequent and/or severe symptoms that indicate their asthma is not well controlled; additionally, parents tend to underestimate the frequency of their child’s symptoms, contributing to inaccurate perceptions of control.
- Poorly controlled asthma causes missed school days for children, lost workdays for parents, activity avoidance, limitations, and emotional burdens that interfere with the everyday lives of children and their families and often force them to accept a much lower quality of life.
- Finally, a widespread lack of understanding about asthma causes, treatment and symptom prevention remains a major obstacle to improved management of this condition.
Program goals for all students are to decrease class time interruptions due to symptoms (increase student performance), fully participate in desired physical activities (promote healthy lifestyle) and improve attendance (increase state funding) to reach their full academic potential and graduate on time.
Although there are several genotypes of asthma, the allergy genotype is predominate in children. (genetically predisposed and environmentally induced). Indoor air quality is a significant concern, because when you combine the hours spent sleeping, working in offices or at school, people, on average, spend the vast majority of their time indoors and therefore exposed, repeatedly, to indoor air pollutants. Poor Indoor Air Quality (IAQ) can affect the comfort and health of all students and staff, which, in turn, can affect concentration, attendance, and student performance. By providing an environment that is healthy for our most sensitive individuals, we can achieve an environment that is healthy for everyone.
Due to the variablity of asthma, flareups can occur with changes in the indoor and outdoor environemt. Please let your child's campus nurse any history or current form of the disease so we can be pro-active and address the needs of your child. Asthma can be controlled; expect nothing less.
Component 2: Environment
Asthma Triggers
Allergies, Irritants, and Infection = Inflammation within the airway
Evidence continues to strengthen that reducing exposure to inhalant indoor allergens can improve asthma control and that a multifaceted approach is required; single steps to reduce exposure are generally ineffective. The cumulative effect of asthma triggers directly affects the level of asthma control and symptom development by reaching the asthmatic’s symptom threshold. If you have asthma, other things can also contribute to reaching your symptom threshold and trigger an asthma attack, including a cold, respiratory infection, or irritants (smoke, fragrances, or pollution).
Individuals who have asthma, exposure to these triggers (irritants or allergens) in which they are sensitive, can increase symptoms and precipitate exacerbations. Effective asthma management is to reduce exposure to these triggers:
- Inhaled Allergies: pollens, molds, dust, animal dander, cockroach
- Irritants: tobacco smoke, exhaust, strong odors, perfumes/ fragrances, chemicals, ozone, weather changes
- Parent Information on Vaping
- What are your asthma triggers? (graphic)
- What are your asthma triggers? (Spanish)
- Childrens Environmental Health Network's Asthma Triggers ebook
- Infection: colds, viruses, flu.
- Co-morbid conditions: sinusitis, rhinitis, gastric reflux, obesity, & sleep apnea; can make asthma more difficult to control.
Infections + Invisible particles + Irritant gases = Inflammation process in many human organs
People spend 90% of their day indoors. NEISD strives to achieve asthma friendly learning environments to reduce exposure during the school day. Parents can do their part in their home environment. Monitoring of Indoor Environment athome/school/work can make this a coordinated effort to address the child’s indoor environment.
- Infectious Microbes:
- Cold/Flu Virus TransmissionPaths in the classroom. Many bacterial and viral respiratory tract infections are associated with the majority of asthma exacerbations and illnesses in both children/adults.
NEISD Best Practice: Non-alcohol microbial hand wipes/foams to reduce transmission andcustodial training.
- Invisible Particles:
- Highaerosols levels in the classroom due to high occupancy level and all occupants bringing in particles from home environment. Airborne particles have the potential tocauseallergic reactions, skin irritation, coughing, sneezing, respiratory difficulties and circulatory system problems.
NEISD Best Practice: Measurement of particles in occupied spaces, upgraded filtrations devices increased ventilation, and educational tools for behavior modification of staff/students.
- Irritant Gases:
- Total volatile organic compounds (TVOC), formaldehyde, body odors, and biological contaminantsare causes for occupant discomfort and poor health outcomes.
NEISD Best Practice: Green-cleaning products used district wide to reduce chemical emissions,removal of fragranced products that emit chemicals, smoke free environment, integrated pestmanagement, anti idling policy & programs,gasphase air filters, as well as outdoor Air Quality Indexmonitoring.
Additional Asthma Resources
- Santitizers vs Disinfectants—what's the best for children
- Exercise is important to maintain basic health and it is important for those with asthma to be active. Resources listed below allow those with asthma to be active outdoors, safely.
- Monitoring of Outdoor Airfor current conditions.
- Outdoor Activity and Play guidelines (time and intensity) Activity Guide for School Days
- South Texas Environmeant Education Research (UT Health Science Center) Allergen Attack Comic Book on Enviromental Triggers Spanish version
The Environmental Protection Agency has recognized NEISD for our efforts in promoting healthy learning environments.
Component 3: Medication
Component 3: Medication
As soon as symptoms start to develop, examine inhaler medication technique and adherence.
Did you know...
Most patients (80%) cannot use their inhaler correctly. This contributes to poor symptom control and flare-ups.
At least 50% of adults and children do not take controller medications as prescribed. Poor adherence leads contributes to poor symptom control and flare-ups.
Two Types of Medications: Controller and Reliever
Controller/Maintenance:
medicines are used to achieve and maintain control of persistent asthma by reducinginflammation in the airways (the primary cause of asthma)
- Taken every day whether or not experiencing asthma symptoms
- Key to managing asthma; does not stop an episode once it starts
- Reduces the inflammation (swelling) in the lungs
- *** The most effective long-term controller medications are those that ease the chronic inflammatory aspect of asthmatic airway.
Quick-Relief Medication:
taken as needed, relaxes airway muscles to give prompt, temporaryrelief of symptoms
- Works in 5 to 10 minutes
- For symptom relief or pre-medicating before exercise
- Frequent use for symptoms may be sign of asthma isnot in control
Every person with asthma should know and understand the action of their prescribed asthma medications. Addtionally, the school nurse should be aware of any and all asthma medications that are prescribed - regardless if taken at school or not. Controller medication use directly impacts the need for albuterol (quick reliever) usage. If the campus nurse knows all the medications, he/she can work with the student on adherence and inhaler technique. Working together can facilitate better asthma control; which directly impacts the student's ability to reach their full academic potential and successful academic year. ThisAsthma treatment poster may aid in this communication. Spanish Respiratory Treatments
Each campus nurse has the IN-Check Dial- which is a device that trains students in proper inhaler technique( inspiratory flow) to ensure proper medication delivery to the smaller airways.With a proper inspiratory flow rate,less puffswill beneededas the medicationis going directly into the small airways (vs back of throat). This benefits asthma student by reducing side effects, optimal medication response,less refills required, saving families money, etc
Does my child need a spacer? If your child uses an Meter Dose Inhaler (MDI) then a spacer is recommended. The spacer slows down the aerosolized particles to allow them to make the turn at the throat and travel into the small airways. This graphic shows where the medication lands with and without a spacer. If the medicine gets to where it needs to go (with a spacer) with the first two puffs, the need for additional puffs may not be needed.
Self-carry of quick relief medication is allowed under Texas law; given the student, campus nurse, physician and parents all agree the student is ready and able to self-carry. NEISD utilizes the American Lung Association Readiness to Self-Carry Assessment tool to guide students as theyprepareinthe knowledge and skillsto self-carry. ALA online version Assessment tool
NEISD In-Stock Albuterol Nebulizer protocol: available for asthma students inimmediate need of reliever medication (Albuterol)toreduce worsening symptoms or avoid emergency transportdue to severe symptoms. Currentdocumention of asthmadiagnosis is required.
Component 4: Education and Management
Component 4: Education and Management
Successful asthma treatment can be attributed to 10% medication and 90% education.
NEISD developed a four component comprehensive approach to asthma control that provides a proactive strategy to address the most common childhood disease that generates multi-day, recurring absenteeism. Using a collective approach, we educate not only our staff in asthma awareness, but also provide education and disease management strategies for our students and parents. This brings awareness to asthmatics, as well as undiagnosed asthmatics, in order for them to receive self-management tools and the empowerment to understand and control the disease. By closing the gap between parents and the medical community, we can help parents improve their child’s quality of life by educating them on the tools available to achieve asthma control.
The Asthma Control Test (ACT - adult) ACT (child 4-11) is an assessment tool that can be used to identify uncontrolled asthma. This test can help identify and assess the asthmatic to determine if medication is adequate and/or assess if environmental influences are causing worsing symptoms and impacting quality of life.
NEISD works with many health care partners in and around San Antonio to raise asthma awareness, education, expectations and disease management strategies. The video Asthma Education for Children and their Families was a collaboration between NEISD Asthma Awareness Education Program and Dr. Kelly Smith. a San Antonio Pediatric Pulmonologist.
Creating Asthma-Friendly Environments for NEISD Students
Improving the quality of life of the child with asthma involves everyone in the child's life - the child, parents/guardians, physicians, and schools - campus nurse, teachers, and administrators - working together.
- Children of age should take action to help manage their asthma. AIMS program for 4th and 5th graders (contact your campus nurse)
- Parents/guardians must understand the definition of asthma control, recognize symptoms, seek proper medical diagnosis and treatment, and manage triggers in the home.
- Physician must be informed of students' level of control to prescribe proper meidcation regimen (parents/guardians and campus nurse work together to insure coordiantion of care).
- Schools (campus nurse, teachers, and administrators) should facilitate asthma friendly practices; treatment modalities, provide education to staff on asthma and its symptoms, and strive to remove asthma triggers from the school indoor environment.
Working together, WE can achieve asthma control for the life of the child with asthma. Our commitment to classroom indoor air quality and asthma management & education results in higher student productivity and attendance; which benefit the district with increased student performance and more importantly, it reduces the burden of uncontrolled asthma on NEISD families.
Your child's campus nurse is an advocate for your child with asthma to have a normal quality of life. Please make sure your campus nurse is aware that your child has asthma or any history of asthma.
American Academy of Allergy Asthma and Immunology: Feb 2021 Study on mask use during COVID 19 Pandemic
Asthma Allergy Network: Why face masks are Criticial for People with Asthma and Allergy during the COVID 19 Pandemic
Asthma Forms & Resources
(online assessment tool) to determine if your student is ready to self carry
This form is critical in addressing onset of symptoms quickly and efficiently. Asthma control can change quickly- everyone needs to be on the same page (home and school)
Information on the process for students with asthma to self-carry per Texas Law
Asthma flares requiring a hospital or ER visit tend to spike in early-to-mid September. Why does it happen? How to be proactive and preventive to avoid a flare?
This form is required for students to self carry inhaler on campus.
Self Carry is the Law: is your 5th grade child ready to self carry?
Community Initiatives
The SA Kids BREATHE (SAKB) program is a free city program whose primary goal is to improve the quality of the lives of children with asthma by teaching them and their family best practices to control their asthma. The SAKB program will help keep kids out of the hospital, keep kids in school, keep parents at work, and save families and healthcare systems money.
