Creating Asthma Friendly Schools in Montana A Presentation to School Staff Your Name Your Affiliation

Asthma is a chronic lung disease that causes episodes of: Coughing Shortness of breath Wheezing Chest tightness

Every day in America: 44,000 people have an asthma attack. 36,000 kids miss school due to asthma. 27,000 adults miss work due to asthma. 4,700 people visit the emergency room due to asthma. 1,200 people are admitted to the hospital due to asthma. 9 people die from asthma. Impact of Asthma Every day in America: 44,000 people have an asthma attack. 36,000 kids miss school due to asthma. 27,000 adults miss work due to asthma. 4,700 people visit the emergency room due to asthma. 1,200 people are admitted to the hospital due to asthma. 9 people die from asthma.

Asthma is a common disease among Montana students 7.1% or an estimated 15,400 Montana children ages 0-17 have asthma. 10.1% of Montana children ages report that they currently have asthma. Asthma affects school attendance and performance With planning, asthma can be managed in the school setting Asthma in Montana Youth

Electronic survey ed to K-12 public school administrators in Montana 193 Responses Is Asthma a Serious Health Concern at Our School?

Electronic survey ed to K-12 public school administrators in Montana 193 Responses How Do Montana Schools Address Asthma? 16.2% of Montana schools provide information on asthma to parents and families. 17.9% of Montana schools provide professional development on how to recognize asthma symptoms, help prevent asthma attacks, and respond to asthma emergencies. 50.6% of health education teacher want more professional development related to asthma. - Source: School Health Profiles 2014

Seven Steps to Creating an Asthma Friendly School Identify students with asthma Allow students easy access to their inhalers Enable students with asthma to participate in activities Educate staff parents and students about asthma Collaborate with families, students, staff and health providers Identify and reduce common asthma triggers Create a school wide protocol for handling an asthma episode

Step 1: Identify students with asthma Every school needs a process to: Annually identify all students with asthma Obtain the proper paperwork to facilitate their care at school Communicate this information with the appropriate staff

Authorization to Possess or Self-Administer Asthma Medication

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Step 2: Allow students easy access to their inhalers

CONTROLLER MEDICATIONS Taken to PREVENT symptoms Reduce swelling Taken daily, usually at home

RESCUE MEDICATIONS Taken in RESPONSE to symptoms Used during an attack All children with asthma need access to these medications

Step 2: Allow students easy access to their inhalers Montana law allows students to self-carry their rescue asthma inhaler and severe allergy medication at school The law also provides for the storage of backup medication at school For students who do not self carry their asthma medication, it is still vital that they have access to their rescue medication at all times, including off campus sporting events and field trips

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Step 3: Create a school wide protocol for handling worsening asthma In an emergency situation, time is of the essence All staff need to know what to do if a student with asthma begins to have an attack

1. Stand or sit up straight 2. Shake the inhaler 3. Put the inhaler in the spacer 4. Put your lips around the spacer mouthpiece and exhale through your nose 5. Press the inhaler and take a deep, slow breath in (for five seconds) 6. Hold breath for 10 sec 7. Exhale 8. Wait one to three minutes before administering a second puff

1. Place the mouthpiece between lips and teeth, forming a tight seal 2. Take a deep breath in 3. Exhale quickly and strongly through the mouthpiece

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Overlap between asthma and allergy Symptoms of anaphylaxis If anaphylaxis is suspected, immediately call 911! Using an EpiPen School Allergy and Anaphylaxis Training dphhs.mt.gov/onlineasthmatrainings

Step 4: Identify and reduce common asthma triggers

What are common asthma triggers?

Mold

Furry and Feathered Pets

Rats and Mice

Outdoor Air Quality

Indoor Air Quality

Cockroaches

Dust Mites

Smoking

Step 4: Identify and reduce common asthma triggers Asthma triggers in the school environment can exacerbate a child’s asthma Simple steps can be taken to reduce common triggers (page 14) School policies such as the elimination of school bus idling, creating a comprehensive tobacco free school, and practicing integrated pest management can reduce asthma triggers

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Step 5: Enable students with asthma to participate in school activities

Around 90% of people with asthma have their symptoms worsened by exercise The symptoms are the same as with all asthma attacks Symptoms may begin during exercise and can be worse five to ten minutes after exercise Symptoms can spontaneously resolve minutes after starting, but may persist for a longer time period

Step 5: Enable students with asthma to participate in school activities Students with well-controlled asthma should be able to participate fully in school activities As necessary, modify activities for children with asthma symptoms Allow students to pre-treat their asthma with quick- relief medications several minutes before exercising Educate coaches about asthma and its relationship to exercise:

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Step 6: Provide education to personnel, parents and students Asthma is a common disease and affects children in virtually every school in Montana Few teachers have received recent training on asthma, and many want additional education The resource guide contains information on asthma education resources for: Students School staff Parents

Managing Asthma: A Guide for Schools (2014 Edition) National Heart, Lung, and Blood Institute Available at: management-school-guide

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Step #7: Collaborate with families, students, staff and health care providers Responsibility for creating an asthma friendly school is not the responsibility of just one person or group Controlling asthma in the school setting requires collaboration and cooperation between all affected parties There are roles and responsibilities in creating asthma friendly schools for: AdministratorsSchool boards TeachersSchool nurses Office staffMaintenance staff Bus driversHealthcare providers ParentsStudents (pp )

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Asthma causes narrowed airways by: Inflammation; and Muscle contraction The two types of asthma medications are: Controller medications Rescue medications With proper authorization, students are allowed to self- carry their own asthma medication by Montana state law Asthma triggers can cause students to experience asthma attacks Common triggers at school include: school bus exhaust, animal dander, and strong cleaning products

Thank you for your time! Questions? Post-class assessment Your Contact Information Montana Asthma Control Program William Biskupiak Your Name