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Asthma in School

Asthma in School. …it’s more serious than you think! Karen P. Kain, MS, RRT-NPS, AE-C Pulmonary Education Specialist Asthma Initiative of Michigan 9/26/2007. WHY TALK ABOUT ASTHMA?. Asthma can be deadly. Most asthma episodes can be prevented.

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Asthma in School

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  1. Asthma in School …it’s more serious than you think! Karen P. Kain, MS, RRT-NPS, AE-C Pulmonary Education Specialist Asthma Initiative of Michigan 9/26/2007

  2. WHY TALK ABOUT ASTHMA? • Asthma can be deadly. • Most asthma episodes can be prevented. • There are legal requirements that affect how schools deal with students who have asthma. • Children with asthma account for almost 15 million missed school days a year, and miss more days on average than their friends who don’t have asthma.1 CDC. Asthma prevalence, health care use and mortality, 2002. Hyattsville, MD: U.S. Department of Health and Human Services; 2004.

  3. Could this happen in your district? Jury Awards $9 Million in Asthma Death at School A California jury that unanimously awarded a mother $9 million in damages for her 11-year old son’s fatal asthma attack at school found the school district guilty of negligence for failing to inform parents of an unwritten school policy that would have allowed the child to carry an inhaler. Gonzalez vs. Hanford Elementary School District, Nos. F033659, F034555, (Super. Ct. Nos. 0031 & 1109). June 2002.

  4. What is Asthma? Chronic inflammatory disease of the airways characterized by: • Recurrent episodes of wheezing • Shortness of breath • Chest tightness/pain • Coughing Airways are supersensitive and react to a variety of stimuli or triggers

  5. Lung Changes During an Asthma Attack • In response to a trigger (something that makes asthma worse): • Airways swell and become narrowed • Bronchial muscles tighten • Mucus further obstructs airways • Breathing becomes difficult

  6. Normal Airway

  7. Asthma Airway Changes

  8. Asthma Attack Airway Changes

  9. Triggers • A variety of stimuli or “triggers” can cause airway inflammation (swelling) and bring on an asthma flare • Eliminating or reducing exposure to these triggers will decrease the need for asthma medications and reduce symptoms

  10. Asthma triggers in a classroom may include: • Stuffed animals • Carpeting • General dusty clutter • Plants • Pets • Mold • Perfume, candles, air fresheners

  11. What is asthma control in children? • No coughing • No difficulty breathing, wheezing, or chest tightness • No waking up at night because of asthma symptoms • Normal activities, including play, sports, exercise, or other school activities

  12. What is asthma control in children, cont’d… • No acute episodes of asthma that require a doctor visit, emergency room visit, or urgent care • No absences from school or activities • No missed days from work or other activities for the parent or caregiver • Normal (or near normal) lung function

  13. What about those inhalers? Does your school allow students to possess and self-administer prescribed medications at school?

  14. MDI Inhaler Law

  15. Do school facilities compromise student health and achievement? • Environmental triggers exacerbate asthma and other respiratory ailments.1 • 50% of schools serving over 20 million children have unsatisfactory environmental conditions such as poor ventilation, heating and lighting.2 • Studies support the link between poor indoor air quality and low student achievement.1,3 1Indoor Air Quality and Student Performance. Environmental Protection Agency, March 2001, Revised 2003. 2U.S. General Accounting Office. School Facilities: The Condition of America’s Schools. 2000. 3Schneider, M. Do School Facilities Affect Academic Outcomes? National Clearinghouse for Educational Facilities, November 2002.

  16. School Facilities and Achievement • Students whose school facilities are in poor condition have test scores about 5.5 percentage points below students whose school facilities are in fair condition, and about 11 percentage points below students in excellent facilities.1 • 90% of U.S. schools were built before 1980, and 50% before 1960.2 1Indoor Air Quality and Student Performance. Environmental Protection Agency, March 2001, Revised 2003. 2U.S. General Accounting Office. School Facilities: The Condition of America’s Schools. 2000.

  17. To think about… • Do you know your district’s policy about the self-possession and use of inhalers (and other quick-relief medication) for students with asthma? • How well does your district monitor indoor air quality related to carpeting in classrooms? • What is your district’s policy on keeping pets or plants in the classroom?

  18. What can schools do?

  19. Be Proactive: • Create local policies that support asthma-friendly schools. • Provide school health services for students with asthma. • Offer asthma-management education to students, staff, and families. • Provide a safe and healthy environment by reducing asthma triggers in the school environment. • Coordinate school, family, and community resources to better manage asthma symptoms and reduce school absences.

  20. Asthma Management Plan (AMP)

  21. State Board of Education Model Asthma Policy

  22. Resources for School Leaders from AASA • AASA’s Indoor Air Quality & Asthma initiatives. • School Governance and Leadership (Spring 2003). • Schoolhouse in the Red (2004 Edition). • “Frequently Asked Asthma Questions” document. • Powerful Practices: A Checklist for School Districts Addressing the Needs of Students with Asthma.

  23. Schoolhouse in the Red

  24. School Governance & Leadership

  25. Completing HSAT • Process Driven by Coordinated School Health Teams • Identify Strengths • Identify Challenges • Develop an Action Plan • Make Policy and Environmental Changes

  26. The HSAT Homepage www.mihealthtools.org/hsat

  27. What is the Healthy School Action Tool (HSAT) ? • Assessment • Action Plan • Implementation • Expected Results: • Partnerships • Policy Change • Environmental Improvement(s) • www.mihealthtools.org/hsat

  28. The HSAT Process

  29. Asthma Strategic Plan for MI Goal 5: Reduce Barriers to Self-Management In People With Asthma Objective 1: Promote development and implementation of asthma-friendly policies in schools. Strategy A: Develop a statewide partnership to address asthma in schools. Strategy B: Facilitate implementation of asthma inhaler law and State Board of Education Asthma management Policy and other asthma-friendly policies in all Michigan schools.

  30. Additional Resources • Strategies for Addressing Asthma Within a Coordinated School Health Program; Centers for Disease Control and Prevention - http://www.cdc.gov/healthyyouth/asthma/strategies.htm • Managing Asthma: A Guide for Schools; National Asthma Education and Prevention Program (NAEPP) http://www.nhlbi.nih.gov/health/prof/lung/asthma/asth_sch.htm • Fit, Healthy, and Read to Learn: National Association of State Boards of Education - http://www.nasbe.org/HealthySchools/fithealthy.html • Quest for the Code Asthma CD Rom Game; Starlight Starbright Children’s Foundation -http://www.starlight.org/site/c.fuLQK6MMIpG/b.1352333/k.2867/Asthma_CD_ROM_Quest_for_the_Code.htm • Schooled in Asthma; American Academy of Pediatrics - http://www.aap.org/schooledinasthma/ • Tools for Schools; Environmental Protection Agency - http://www.epa.gov/iaq/schools/toolkit.html • Open Airways for Schools & Asthma 101 (for Elementary School children) - http://www.lungusa.org/ • Power Breathing™ (for Teens) - http://www.aafa.org/display.cfm?id=4&sub=79&cont=436

  31. For More Information • For more information on AASA’s efforts to address asthma in schools please visit www.aasa.org/focus. • For more information on AIM school initiatives visit www.GetAsthmaHelp.org

  32. Asthma Contacts • Karen P. Kain, MS, RRT-NPS, AE-C President, Asthma Coalition of NW MI (231) 935-6736 • Asthma School Coordinator: Shawn Cannarile, MAEd Michigan Public Health Institute 517-324-7385 or scannari@mphi.org • Asthma Initiative of Michigan www.GetAsthmahelp.org

  33. References CDC.Asthma prevalence, health care use and mortality, 2002. Hyattsville, Maryland: US Department of Health and Human Services, CDC, National Center for Health Statistics, 2004. Gonzalez vs. Hanford Elementary School District, Nos. F033659, F034555, (Super.Ct. Nos. 0031 & 1109). June 2002 Indoor Air Quality and Student Performance. EPA, March 2001, Revised 2003. School Facilities: The Condition of America’s Schools. US General Accounting Office 2000. Schneider, M. Do School Facilities Affect Academic Outcomes? National Clearinghouse for Educational Facilities, November 2002.

  34. HSAT Expansion • New Topic Areas: • Asthma Management • Violence and Injury Prevention • New Format: “a la carte” design allows schools to choose topics to assess • More resources! • Better tools!

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