9/30/2013. Asthma in the Classroom: What do teachers need to know? Asthma Impact. Asthma is Common

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Asthma in the Classroom: What do teachers need to know? Pulmonary Rehabilitation Asthma Impact Asthma affects over twenty five million people nationwide causes 10.

1 Asthma in the Classroom: What do teachers need to know? Pulmonary Rehabilitation Asthma Impact Asthma affects over twenty five million people nationwide causes 10.5 million lost school days annually third-ranking cause of hospitalization among those younger than 15 years of age Estimated cost of asthma in the U.S. is $56 billion per year (direct and indirect costs) Source: EPA Asthma Facts 2013, Asthma is Common Nationally, 9.5% of children have asthma Rates are twice as high for schoolchildren in some cities in MA Holyoke- 18.7% Springfield- 17.2% High rates of uncontrolled asthma Asthma hospitalizations are more than double the state rate in both Holyoke and Springfield Sources: National Health Interview Survey Data, 2011, Baystate Health Community Health Needs Assessment 2013 CDC. Asthma s Impact on the Nation, 1

2 Asthma Impact School Asthma can affect School attendance Ability to concentrate Overall academic performance Overall quality of life What is asthma? Overview What is Asthma? Chronic lung disease that can affect a person s breathing Asthma can range from mild to severe Image from 2

3 What is Asthma? In asthma, two main things happen: 1. Muscles tighten around the airways (bronchoconstriction) 2. The insides of the airways swell (inflammation) and make mucus *Modified from GSK Programs to Go What do you really know about asthma? Common Asthma Symptoms Cough Wheezing/whistling with breathing Hard to breathe Chest tightness Tired or fatigued Asthma Triggers What is an asthma trigger? Things in the environment that can cause a person with asthma to have asthma symptoms (commonly called attacks, flare-ups or exacerbations ) Types of asthma triggers Allergens things that trigger allergies Irritants substances that irritate respiratory passages Other infections, exercise, cold air Asthma triggers are different for everyone 3

main types of asthma medication: Rescue/quick-relief medications Controller medications Quick Relief Medications

4 Environmental Asthma Triggers How does the environment impact asthma? Environment can affect who can get asthma when someone gets asthma how bad the asthma is Asthma Medications Two main types of asthma medication: Rescue/quick-relief medications Controller medications Quick Relief Medications Provide quick treatment to reduce airway blockage when having asthma symptoms Stops tightening of muscles around airway (bronchospasm) Example: Albuterol 4

Controller Medications Taken DAILY to control persistent asthma

Pulmicort, Symbicort Asthma in the Classroom Asthma Triggers

Example - found in classroom carpets and clutter Animal dander

5 Controller Medications Taken DAILY to control persistent asthma Used to stop chronic inflammation Examples: Flovent, Advair, Pulmicort, Symbicort Asthma in the Classroom Asthma Triggers Triggers in the Classroom Allergens Examples: Dust mites Example - found in classroom carpets and clutter Animal dander Example - from class pets or pet hair on student clothes Cockroach droppings 5

6 Triggers in the Classroom Allergens Examples: Pollen Example - from plants in classroom or outdoors Molds 3 parts of mold can cause a reaction spores, VOCs (mold smell) and body parts (the mold itself) Examples from wet drywall, rug or saturated plants Near intake vent or window Keep classroom allergen free! Make sure classroom is clean Dust with damp rag (microfiber if possible) Wash blankets, furry costumes and stuffed animals weekly in hot water Use throw rugs, whenever possible, that can be machine washed periodically or replaced Furry pets may be a trigger and should be avoided in classroom per protocol No dust mites here! Keep classroom allergen free! Make sure classroom is cleanable No dust mites here! Remove clutter to prevent accumulation of dust Clear areas for custodians to dust, mop and vacuum 6

pests and having food spoil Avoid hissing cockroaches as pets if they are a trigger for students or staff Identify possible sources of mold Prevent

7 Keep classroom allergen free! Prevent allergens from entering or multiplying Stay inside/close windows on high pollen days Keep pet and people food tightly covered to prevent attracting pests and having food spoil Avoid hissing cockroaches as pets if they are a trigger for students or staff Keep classroom allergen free! Identify possible sources of mold Keep classroom allergen free! Prevent allergens from multiplying Keep plants well drained Locate items that leak away from carpet Locate plants away from air vents to prevent circulation of allergens (mold & pollen) Identify sources of water leaks and report to maintenance 7

8 Keep classroom allergen free! Prevent exposure to allergens Make sure ventilation system is working and report to custodian if it is not Locate children s clothes with smoke and pet allergens away from occupied areas and ventilation system Triggers in the Classroom Irritants - Chemical Products with fragrance or odor Personal Care Products - perfume, scented lotions Curriculum Products permanent markers, scented markers Cleaning and maintenance products air fresheners solvent-based cleaning products disinfectants and sanitizers i.e. bleach Triggers in the Classroom Irritants - Particulate Airborne particles in the building - chalk dust, from buffing waxed floors High air pollution days Note: Though it should not be found in the classroom, it is important to be aware that second-hand smoke is a strong asthma trigger as many children have family members that smoke 8

9 Triggers in the Classroom Irritants - Particulate Exhaust (indoor/outdoor) Vehicle - school bus, delivery and car idling Landscaping equipment - snow blower, lawn mower, leaf blower Triggers in the Classroom Irritants - Particulate o Exhaust - Office Equipment Copier Laminating machine Laser printer Keep classroom free of chemical irritants! Create a fragrance free classroom No fragrances here! Avoid use of perfumes, powders, lotions, air fresheners, scented markers, etc. Use safe products Check with your school district about using green cleaning products Springfield Public School District has a list of approved cleaning products for use and teachers should not bring in products from home. Use microfiber whenever possible Do not dust or clean while children are present Only use cleaning products when children are absent Only trained custodians using approved products should disinfect after hours 9

10 Keep classroom irritant free! Stay inside/close windows on poor air quality/high ozone days Make sure ventilation system is working properly Promote anti-idling policies at your school Indoor Air Quality (IAQ) Reporting If you find a ventilation or odor problem OR If you suspect that staff or students have a reaction or symptoms due to conditions in the building Report it to your principal who has the authority to have it investigated. Ask your principal to report back on any action based on the investigation. Check with your district to see if there is a specific protocol for investigating IAQ problems. Asthma Triggers at School Exercise Exercise and asthma Exercise can trigger asthma Some children with asthma take quick-relief medication before they exercise Children with asthma should warm-up before exercise If a child with asthma is wheezing during exercise, it is a sign of uncontrolled asthma They should talk to their doctor to see if they need to adjust their medications Children with asthma should not be excluded from exercise or recess unless they have written physician s instructions to do so Asthma can be controlled and children with asthma can lead active, healthy lives! 10

11 Asthma Triggers at School Weather & Outdoor Air Check the weather and outdoor air forecast Cold air can make asthma worse High air pollution/ozone days can trigger asthma Pollen can trigger asthma On cold days, wearing a scarf over nose and mouth warms and humidifies air Close windows and limit exposure to outdoor air on high pollution, ozone and pollen days Asthma Triggers at School Other Some other asthma triggers Respiratory infections Food Additives Some food additives such as sulfites can trigger asthma flare-ups Emotional Stress Stress during an asthma flare-up can produce rapid breathing or hyperventilation which can make the episode worse Asthma in the Classroom What to be aware of 11

12 Asthma in the Classroom Know Early Warning Signs of Asthma Episode cough wheeze chest tightness shortness of breath runny or stuffy nose sneeze headache funny feeling in chest stomach ache poor appetite itchy throat or chin glassy eyes feeling tired coughing or waking at night *modified from ALA Asthma Education Certification Course and Developing an Effective Asthma Action Plan by Dr. Matthew Sadof Asthma in the Classroom Asthma Episodes What to do during an asthma episode Stay calm Keep child calm Have the child try to stay relaxed and focus on breathing Contact the school nurse Always make sure the nurse is available before sending a child to the nurse s office Never send a child experiencing asthma symptoms alone to the nurse s office Asthma in the Classroom Danger Signs of Asthma Episode Know danger signs of an asthma episode Difficulty speaking Lips or fingernails turn gray or blue Heart rate is very fast Noisy breathing (may not be present if severe airway constriction) Visible drawing in or sinking of chest (retractions) when student inhales Quick-relief medicine does not improve the signs listed above Contact school nurse immediately! 12

13 Asthma in the Classroom Potential Medication Side Effects Be Aware of Potential Medication Side Effects Anxiety Restlessness Hyperactivity Rapid heartbeat Thrush Sore throat Asthma Medication Devices Be Aware of Types of Medication Devices Metered dose inhalers Nebulizer Dry powder inhalers Spacers Asthma at School Asthma Action Plans All children with asthma should have a written Asthma Action Plan at school, home and physician s office Asthma action plans provide information on How to assess and monitor asthma symptoms and lung function (green, yellow and red zones) Medications to take and when to take them What to do during an asthma flare-up when things get worse Triggers to avoid *modified from ALA Asthma Education Certification Course and Developing an Effective Asthma Action Plan by Dr. Matthew Sadof 13

Plan on file with the school nurse Together we can help children in our schools control asthma so that they can lead active, healthy lives! Thank you!

14 Asthma Action Plan- Example Classroom Asthma Management Summary Create a healthy classroom by reducing exposure to triggers! Encourage policies in your school to reduce triggers Be aware of asthma symptoms Know warning signs of an asthma episode and what to do Encourage all children with asthma to have an Asthma Action Plan on file with the school nurse Together we can help children in our schools control asthma so that they can lead active, healthy lives! Thank you! If you have any questions about asthma or would like more information, visit: Pioneer Valley Asthma Coalition, American Lung Association, Brought to you by: Pulmonary Rehabilitation Presentation developed by: Michele Hart, RN, BSN, AE-C, Baystate Pulmonary Rehab; Ann Ottalagana, American Lung Association; Kathleen Szegda, and Sarita Hudson, Pioneer Valley Asthma Coalition 14

Asthma. January 2011

Asthma. January 2011 Asthma January 2011 What is Asthma? Asthma is a lung disease that affects the breathing tubes (airways) that allow air to go in and out of the lungs. Normal airways are wide open, so air can go in and