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Asthma Basics

Developed and Provided by: Minnesota Department of Health Asthma Program. Asthma Basics. Minnesota Department Of Health www.health.state.mn.us/divs/hpcd/cdee/asthma. As You View This Program. Consider how many people you know who have asthma?

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Asthma Basics

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  1. Developed and Provided by: Minnesota Department of Health Asthma Program Asthma Basics

  2. Minnesota Department Of Healthwww.health.state.mn.us/divs/hpcd/cdee/asthma

  3. As You View This Program.. • Consider how many people you know who have asthma? • How will you use the information you receive here today? • How can you help students prevent their asthma symptoms from appearing? • How can you help your schools health office staff reduce asthma triggers at school?

  4. Goal Setting Think about what you would like to achieve here today Pick one goal to work toward when you go back to your classroom or work place

  5. Asthma: • Accounts for 14 million lost school days annually3 • Is the most common chronic disease causing absence from school2 • Is the leading cause of hospitalizations (chronic) among children under 152 • 1 in 13 school children have asthma1 • 6.3 million children under 18 have asthma1 1 Asthma Prevalence, Health Care Use, and Mortality, 2000-01, National Center for Health Statistics, CDC 2 Asthma in Children Fact Sheet, American Lung Association, June 17, 2003 3 Surveillance for Asthma - United States, 1980-99, MMWR Surveillance Summaries, CDC, March 29, 2002

  6. Minnesota Children In a 2003 MDH survey of more than 5,000 7th & 8th graders at 15 junior highs outside the metro area- • 1 in 12reported they currently have asthma In a 2001 MDH survey of 13,000, 9th - 11th graders in rural MN- • 1 in 11reported they currently have asthma

  7. This Means.. In a class of 30 children, you can expect 2 to 3 students WILL have asthma! This number varies depending on age and geographical location.

  8. “Healthy Children Learn Better”

  9. The Goal Of Asthma Management “Children should live happy, healthy, physically active lives, without asthma symptoms slowing them down “

  10. Impact Of Asthma On Students School Performance • Poorly controlled asthma has a negative impact on school performance in both academic achievement and physical education

  11. Impact Of Asthma On Students cont... Psychosocial • Poor self-esteem • Anxiety about asthma • Fear of becoming ill at school • Anxiety about exercise at school • Fear of being different

  12. What Is Asthma? Asthma is a chronic disease that causes: • Tightening of the muscles surrounding the airways (Bronchoconstriction/spasm) • Swelling of the small airways (bronchioles) • Over production of sticky mucus in the airways

  13. Group Exercise Straw Exercise • Stand up • Place the straw in your mouth • Try to breathe! • This is what is may feel like when a child is having a severe asthma episode

  14. Airway Obstruction Copyright 3M Pharmaceuticals 2004

  15. Common Symptoms Of Asthma • Frequent cough, especially at night • Shortness of breath or rapid breathing • Chest Tightness • Chest pain • Wheezing • Fatigue • Behavior changes

  16. Every Child Is Unique! • Wheezing and coughing are the most common symptoms -but- • No two children will have the exact same symptoms or the same trigger • Every child who has a diagnosis of asthma should have access to a rescue inhaler! • Every child who has asthma should have an asthma action plan at school (AAP)

  17. Handling Asthma Episodes

  18. What’s An “Episode”? • An asthma episode occurs when a child is exposed to a trigger or irritant and their asthma symptoms start to appear • This can occur suddenly without a lot of warning, or brew for days before the symptoms emerge • Episodes are preventable by avoiding exposure to triggers and taking daily controller medications (if prescribed)

  19. How Do I Handle An Asthma Episode At School? • Remain calm and reassure the child • Contact the school health office for assistance • Check the child's asthma action plan or individualized health plan for actions • Give “rescue or reliever” medications if ordered and available (some students carry their own asthma inhalers with them)

  20. Handling An Episode cont.. 5. If identified, get the child away from the trigger 6. Have the child sit up and breathe slowly- in through the nose, out through pursed lips slowly 7. Have the child sip room temperature water/ fluids 8. Contact the parent or guardian as necessary - AND-

  21. Do NOT Leave The Child Alone!

  22. Call 911 if.. • Lips or nail beds are bluish • Child has difficulty talking, walking or drinking • Quick relief or “rescue” meds (albuterol) is ineffective or not available • Neck, throat, or chest muscles are pulling in (retracting) • Nasal flaring occurs when inhaling • Obvious distress • Altered level of consciousness/confusion • Rapidly deteriorating condition

  23. There should not be any delay once a child tells you they are having trouble breathing OR You notice something's happening!

  24. What Causes Asthma? • Asthma may be caused by genetic, immune and/or environmental factors, and is often associated with eczema (scaly skin patches) and allergies • Researchers do not understand all of the causes of asthma or its increasing prevalence • It boils down to “We just don’t really know for sure”

  25. What Causes Asthma cont.. • Of the 17 million asthma sufferers in the US, 10 Million (approx. 60%) have allergic asthma. 3 million of those are children1 • Exposure to certain allergens trigger asthma symptoms to begin • Exposure to certain irritants can also set an asthma episode in motion 1National Institute of Environmental Health Sciences

  26. Triggers And Irritants Copyright 2004, 3M Pharmaceuticals

  27. Seasonal pollens Animal dander /saliva/urine Dust mites Cockroaches/mice/rat droppings and urine Mold Some medications Some foods Strong emotional feelings Common Allergens (Triggers)

  28. Exercise Cold air Chalk dust Viral/upper respiratory infections Air pollution Tobacco smoke or secondhand smoke Chemical irritants and strong smells Strong emotional feelings Diesel fumes Cleaning supplies Common Irritants (Triggers)

  29. Dust Mites • Live in pillows, carpet, fabric-covered furniture, curtains • What to do: • Avoid bringing in fabric covered furniture from home • Vacuum often when people with asthma/allergies are not in the area (HEPA filter vacuum cleaners) • Dust book cases and furniture frequently • Keep room humidity < 50% if possible

  30. Mold • Moisture control is key • What to do: • Report leaks and wet/moist areas right away for school custodian • Wash mold off surfaces using plain soap and water • Replace moldy porous items such as ceiling tiles & carpet • Avoid installing carpet in areas exposed to regular moisture such as drinking fountains & sinks R7

  31. Animals In The Classroom • Dander, urine & saliva are triggers • Triggers can remain after pet is removed • What to do: • Prohibit/remove animals from schools • If removal is not possible: • Keep animals in cages • Clean cages often • Keep animals away from fabric furniture, carpet & ventilation system • Locate sensitive students away from animals • Pre-notify parents if animals with fur/feathers visit R1

  32. Pests • Droppings or body parts can trigger asthma • What to do: • Use integrated pest management (IPM) methods • Don’t leave food, water or garbage exposed • Don’t eat or drink in classroom • Seal entry points for pests • Custodians should use pesticides only as needed R7

  33. Secondhand Smoke • Is an irritant trigger causing asthma in children • State law prohibits tobacco use in K-12 public schools • What to do: • Enforce smoking bans (for students, parents and teachers) • Include anti-smoking message in curriculum

  34. Outdoor Air • Ozone & fine particles are biggest concern • Actions: • Sign up for Air Quality Index notice • Pollution Control Agency sends e-mail alerts when they expect poor air quality (regional) • Avoid being outside at high pollen count times, especially if students are allergic to particular pollens

  35. School Buses • Diesel fuel emissions are an irritant and can set off an asthma episode in many children • State law requires: • Reduce unneeded idling in front of schools • Reroute bus parking zones away from air intakes, if possible • What to do: • Post “no idling” signs • Maintain bus fleet • Invest in cleaner fuels • Replace old buses with cleaner running onesR3, R4

  36. Exercise Induced Asthma

  37. What Is Exercise Induced Asthma (EIA)? • Tightening of the muscles around the airways (bronchospasm) • Distinct from allergic asthma in that it does NOT cause swelling and mucus production in the airways • Can be avoided by taking pre-exercise medications and by warming up/cooling down

  38. EIA - What Happens? • Symptoms include coughing, wheezing, chest tightness and shortness of breath • Symptoms may begin during exercise and can be worse 5 to 10 minutes after exercise • EIA can spontaneously resolve 20 to 30 minutes after starting • Can be avoided by doing the following:

  39. Preventing Exercise Induced Asthma (EIA) • Become familiar with Asthma Action Plans • Student should use reliever (Albuterol) 15 -30 minutes before activity • Do warm-up/ cool-down exercises before and after activities • Check outdoor ozone/air quality levels www.aqi.pca.state.mn.us/hourly/ • Never encourage a child to “tough it out” when having asthma symptoms

  40. Medications

  41. Two Categories Of Medications • Controller Medications • Taken every day to prevent swelling in the lungs • Reliever or Rescue Medications • Taken only when needed to relieve symptoms • Or to prevent exercise induced asthma from developing (taken before strenuous exercise)

  42. Controller Medications • Keep swelling and mucus from developing in the lungs • Must be taken EVERY day even when the child is not having symptoms • Inhaled corticosteroids (ICS’s) are the most common and effective way to control asthma • Help prevent asthma exacerbations from developing!

  43. Rescue Or Reliever Medications • Are taken when asthma symptoms are appearing (asthma episode) • Are taken 15-30 minutes before strenuous exercise/activity by children with EIA • Do NOT reduce or prevent swelling from developing in the lungs • May be carried in school by a student only IF approved by the doctor, school nurse and parent!

  44. Picture courtesy of American Lung Association of the Inland Counties CA 2004

  45. Spacers Or Holding Chambers • Most MDI’s (Metered dose inhalers) must be used with a spacer or holding chamber • This device attaches to the MDI and allows the user to breathe in more medication effectively • The physician must write an order for it when prescribing your reliever medication • Dry powder inhalers do NOT require spacers

  46. Typical Spacers/Holding Chambers

  47. Tools To Help Manage Asthma

  48. Peak Flow Meters (PFM)

  49. Peak Flow Meters • Measures how well the student’s lungs are doing at that moment • Associated with the Green-Yellow-Red system of managing asthma symptoms • Congruent with asthma action plans • Helps students and families self-manage asthma

  50. Symptoms and PFM Diary

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