School nurse Leta Lofton knows why it’s so important for young children to understand their own asthma. She had one student who thought her daily medication was the same as a rescue inhaler, designed to be used only when asthma symptoms suddenly flare up. She even heard of a grade-school student at another school who overdosed on her asthma medicine trying to treat breathing problems on her own.
Hearing that a child has asthma can be scary for parents. But it gets even scarier when the children go to school. They spend five or more hours a day away from parents who can monitor their symptoms and jump in to stop an asthma attack. For school nurses, the scariest time of all can be when they discover a student has asthma because the child is having an asthma attack at school. That, too, has happened to Lofton.
Teaching children about asthma
Asthma is the most common chronic illness in children. So it’s no surprise asthma is a leading cause of missed school days. The U.S. Centers for Disease Control and Prevention says that children ages 5 to 17 miss 10.5 million days of school because of asthma.
Being sure children -- and their parents -- understand their own illness is an important step to help them avoid asthma attacks. The American Lung Association has a program to do just that: “Open Airways for Schools,” aimed at kids ages 8 to 11. The program “teaches kids to manage their asthma day-to-day rather than crisis- to-crisis,” says Marla Taylor, a public health nurse who has taught the Open Airways program.
That is the exact same goal of a program called “Enhancing Care for Children with Asthma.” Through this program, Blue Cross and Blue Shield of Oklahoma funded Open Airways for children in the Tulsa Public School system. The funding ensures every child in the program gets a peak-flow meter to measure lung function and a spacer for use with their inhalers. Spacers are tube-like gadgets that attach to an inhaler and make it easier to breathe the medicine deeply into the lungs.
The Open Airways course uses trained asthma educators who volunteer to teach six lessons about asthma. After completing the course, children should be able to:
“All these things allow them to take ownership of their asthma,” says Patrick Hattaway of the American Lung Association. “It helps get them planning ahead and making sure they will be able to control their asthma attacks. Then, when they go to grandma’s house and she has cats, they know they better have their medicine with them and know how to use it.”
Working in schools
Open Airways is an after-school program in Tulsa. Katie Kirkpatrick, a pharmacy student, was a volunteer instructor. Just a handful of children had asthma. “The kid with asthma became the expert in the class,” she says. Children without asthma learned to recognize symptoms and help their friends.
Teaching Open Airways in a group including kids with and without asthma helps them deal with peer pressure, too, says Taylor. Once all the students know what asthma is and how to control it, they can better understand the need to make allowances for a child with asthma.
“They can still spend the night at a friend’s house who has a pet,” she says. “They just need to take precautions. It’s no different than anyone else who might have another problem. If I have a broken leg, it means I can’t do a sleepover in your upstairs bedroom, but we can still do it in the living room.”
Getting parents involved
A key part of Open Airways is teaching parents about their children’s asthma. The kids get handouts to take home, and parents are invited into the school. Part of this involves asking parents to bring an Asthma Action Plan to school.
That is a document filled out by a doctor that outlines specific asthma control steps geared to the needs of that particular child. The plan lists the child’s medications, asthma triggers , and symptoms. Most importantly, it gives direction on what to do once symptoms start. The child’s plan should be on file at school, and copies should be given to coaches, day care providers, and anyone else directly in charge of a child with asthma.
When school nurse Leta Lofton gets an Asthma Action Plan for a student, she lets the child’s teacher know and works with the student. “I tell them that any time they are short of breath, coughing, or they are wheezing, go up and tell the teacher, ‘I need to go get my inhaler.’”
While teaching the students is important, having parents understand the illness is critical, Lofton says. She remembers two fifth-grade students, both with uncontrolled asthma so bad “they didn’t know what normal breathing is. Every time they came to my office, they would be wheezing. It was like putting duct tape on a dam that was ready to break.”
When the school invited parents to its Open Airways program, the parents of those two boys were the only ones who came. But what a difference it made. “They both got allergy testing. They got routine meds and could get specific about their asthma triggers. For the first time, they knew what it was like to breathe,” Lofton says. “That was a major accomplishment through Open Airways .”
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