1. Asthma Keeping our Student’s Safe

2. Content What Asthma Is and Isn’t What Happens Asthma Treatment Management Strategies Role of the School Nurse

3. Asthma Is Not Infectious Contagious

4. ASTHMA Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing. Wikipedia

5. Common Asthma Triggers Exercise Cold Air Smoke/pollution Allergens such as pet dander, dust mites, cockroaches, molds, and pollen Colds, viruses, and various respiratory infections Medicines/chemicals Coughing, yelling, and laughing Acute stress

6. Asthmatic Response to Triggers BRONCHOSPASM –Windpipe muscles tighten INFLAMMATION –Windpipe lining swells –Mucus forms in the windpipe

7. Asthma Onset Symptoms Restlessness Irritability Cough Wheezing Shortness of Breath Tightness in the Chest

8. Asthma Treatment BRONCHODILATORS –Quick Relief or “rescue” medication –Ventolin –Proventil –Maxair –Albuterol –Taken 15 or 20 minutes ahead of time, these medications can prevent symptoms triggered by exercise or exposure to cold

9. ANTI-INFLAMMATORIES/STERIODS Reduce swelling and mucous production in the airways Advair Azmacort Flovent Pulmicort

10. SPACERS FOR INHALER USE

11. DON’T SHARE INHALERS

12. Asthma Management Know the “triggers” that initiate an episode Avoid known “triggers” Use of peak flow meter to monitor status Recognize the symptoms of an episode onset Have medications immediately available Allow adequate time for recovery

13. EXERCISE – ONE OF THE MOST COMMON TRIGGERS ANYONE who has asthma has the potential for exercise induced asthma (EIA) EIA symptoms are likely to be intense for 5 to 10 minutes and will usually resolve in 15-30 minutes ANY recess, physical education class, or extra-curricular sport activity has EIA potential

14. Contributing Factors Air Temperature and Humidity Wind, Dust, and Pollen Counts Air Pollution Health Status January 11 th 2010 Air Quality Index for Salt Lake City 142 San Francisco 67 Las Vegas 23 www.airquality.utah.gov

15. Exercise Management Know students at risk for exercise induced asthma Promote student responsibility for self-care Encourage premedication as appropriate Encourage warm up/cool down exercises

16. Exercise Management Be alert for symptom onset Have asthma management and emergency plans Report any respiratory concerns

17. Staff Cooperation Everyone’s cooperation is essential Physical education teachers, coaches, and playground supervisors have a special responsibility Encourage student responsibility for self and others Be prepared for emergencies –Know the students –Know yourself –Know CPR

18. Episode Management Never leave a child alone !!! Call for help Help student use his/her medication Assist in tripod position to maximize respiratory function Provide a calm, reassuring atmosphere –Tripod position: refer to picture.

19. Role of the School Nurse Provide “Health Care Plans” for those students that have asthma Provide asthma education programs for teachers and students Audit medication administration procedures

20. Medication Administration Parent’s need to sign a form authorizing staff to administer medication –“Authorization of School Personnel to Administer Medication” –Staff administering medications need to track medication use on a “Daily Medication Tracking Form” If the child is responsible they can carry their inhaler. Parent’s need to sign an authorization form for the student to carry medication. “Self Medication Self-Administration Form” Do NOT accept medication if it is not labeled with a Rx label from the pharmacy. This includes over-the-counter medications. Medication is stored in a locked cabinet or container

21. THE END Your School Nurse Suzanne Tanner RN, RDH 101 East 200 North Heber City, Utah 84032 435-654-0280 ext. 4144 435-654-8289 cell suzanne.tanner@wasatch.edu

22. References Reilly, D. (2000). Managing Asthma Triggers Training Manual. National Association of School Nurses. Utah Department of Health (November 2010). Asthma and Air Pollution: Associations Between Asthma Emergency Department Visits, PM 2.5 Levels, and Temperature Inversions in Utah.

23. For more information visit these WEB SITES www.health.utah.gov/asthma www.winningwithasthma.org www.airquality.utah.gov www.health.utah.gov/asthma/air%20qualit y/pm25.html - information on recess guidelines.www.health.utah.gov/asthma/air%20qualit y/pm25.html