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

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Presentation on theme: "Asthma Basics Developed and Provided by: Developed and Provided by: Minnesota Department of Health Asthma Program."— Presentation transcript:

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

2 Minnesota Department Of Health

3 As You View This Program.. Consider how many people you know who have asthma? Consider how many people you know who have asthma? How will you use the information you receive here today? 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 students prevent their asthma symptoms from appearing? How can you help your schools health office staff reduce asthma triggers at school? 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 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 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 annually 3 Accounts for 14 million lost school days annually 3 Is the most common chronic disease causing absence from school 2 Is the most common chronic disease causing absence from school 2 Is the leading cause of hospitalizations (chronic) among children under 15 2 Is the leading cause of hospitalizations (chronic) among children under in 13 school children have asthma 1 1 in 13 school children have asthma million children under 18 have asthma million children under 18 have asthma 1 1 Asthma Prevalence, Health Care Use, and Mortality, , National Center for Health Statistics, CDC 2 Asthma in Children Fact Sheet, American Lung Association, June 17, Surveillance for Asthma - United States, , MMWR Surveillance Summaries, CDC, March 29, 2002

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

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

8 Healthy Children Learn Better Healthy Children Learn Better

9 The Goal Of Asthma Management Children should live happy, healthy, physically active lives, without asthma symptoms slowing them down 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 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 Poor self-esteem Anxiety about asthma Anxiety about asthma Fear of becoming ill at school Fear of becoming ill at school Anxiety about exercise at school Anxiety about exercise at school Fear of being different Fear of being different

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

13 Group Exercise Straw Exercise Stand up Stand up Place the straw in your mouth Place the straw in your mouth Try to breathe! Try to breathe! This is what is may feel like when a child is having a severe asthma episode 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 Frequent cough, especially at night Shortness of breath or rapid breathing Shortness of breath or rapid breathing Chest Tightness Chest Tightness Chest pain Chest pain Wheezing Wheezing Fatigue Fatigue Behavior changes Behavior changes

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

17 Handling Asthma Episodes

18 Whats An Episode? An asthma episode occurs when a child is exposed to a trigger or irritant and their asthma symptoms start to appear 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 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) 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? 1. Remain calm and reassure the child 2. Contact the school health office for assistance 3. Check the child's asthma action plan or individualized health plan for actions 4. 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 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 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 7. Have the child sip room temperature water/ fluids 8. Contact the parent or guardian as necessary - AND- 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 Lips or nail beds are bluish Child has difficulty talking, walking or drinking Child has difficulty talking, walking or drinking Quick relief or rescue meds (albuterol) is ineffective or not available Quick relief or rescue meds (albuterol) is ineffective or not available Neck, throat, or chest muscles are pulling in (retracting) Neck, throat, or chest muscles are pulling in (retracting) Nasal flaring occurs when inhaling Nasal flaring occurs when inhaling Obvious distress Obvious distress Altered level of consciousness/confusion Altered level of consciousness/confusion Rapidly deteriorating condition 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 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 Researchers do not understand all of the causes of asthma or its increasing prevalence It boils down to We just dont really know for sure It boils down to We just dont 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 children 1 Of the 17 million asthma sufferers in the US, 10 Million (approx. 60%) have allergic asthma. 3 million of those are children 1 Exposure to certain allergens trigger asthma symptoms to begin Exposure to certain allergens trigger asthma symptoms to begin Exposure to certain irritants can also set an asthma episode in motion Exposure to certain irritants can also set an asthma episode in motion 1 National Institute of Environmental Health Sciences

26 Triggers And Irritants Copyright 2004, 3M Pharmaceuticals

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

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

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

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

31 Animals In The Classroom Animals In The Classroom Dander, urine & saliva are triggers Dander, urine & saliva are triggers Triggers can remain after pet is removed Triggers can remain after pet is removed What to do: What to do: Prohibit/remove animals from schools Prohibit/remove animals from schools If removal is not possible: If removal is not possible: Keep animals in cages Keep animals in cages Clean cages often Clean cages often Keep animals away from fabric furniture, carpet & ventilation system Keep animals away from fabric furniture, carpet & ventilation system Locate sensitive students away from animals Locate sensitive students away from animals Pre-notify parents if animals with fur/feathers visit Pre-notify parents if animals with fur/feathers visitR1

32 Pests Pests Droppings or body parts can trigger asthma Droppings or body parts can trigger asthma What to do: What to do: Use integrated pest management (IPM) methods Use integrated pest management (IPM) methods Dont leave food, water or garbage exposed Dont leave food, water or garbage exposed Dont eat or drink in classroom Dont eat or drink in classroom Seal entry points for pests Seal entry points for pests Custodians should use pesticides only as needed Custodians should use pesticides only as neededR7

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

34 Outdoor Air Outdoor Air Ozone & fine particles are biggest concern Ozone & fine particles are biggest concern Actions: Actions: Sign up for Air Quality Index notice Sign up for Air Quality Index notice Pollution Control Agency sends alerts when they expect poor air quality (regional) Pollution Control Agency sends alerts when they expect poor air quality (regional) Avoid being outside at high pollen count times, especially if students are allergic to particular pollens 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 Diesel fuel emissions are an irritant and can set off an asthma episode in many children State law requires: State law requires: Reduce unneeded idling in front of schools Reduce unneeded idling in front of schools Reroute bus parking zones away from air intakes, if possible Reroute bus parking zones away from air intakes, if possible What to do: What to do: Post no idling signs Post no idling signs Maintain bus fleet Maintain bus fleet Invest in cleaner fuels Invest in cleaner fuels Replace old buses with cleaner running ones R3, R4 Replace old buses with cleaner running ones R3, R4

36 Exercise Induced Asthma

37 What Is Exercise Induced Asthma (EIA)? Tightening of the muscles around the airways (bronchospasm) 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 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 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 include coughing, wheezing, chest tightness and shortness of breath Symptoms may begin during exercise and can be worse 5 to 10 minutes after exercise 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 EIA can spontaneously resolve 20 to 30 minutes after starting Can be avoided by doing the following: Can be avoided by doing the following:

39 Preventing Exercise Induced Asthma (EIA) Become familiar with Asthma Action Plans Become familiar with Asthma Action Plans Student should use reliever (Albuterol) minutes before activity Student should use reliever (Albuterol) minutes before activity Do warm-up/ cool-down exercises before and after activities Do warm-up/ cool-down exercises before and after activities Check outdoor ozone/air quality levels Check outdoor ozone/air quality levels Never encourage a child to tough it out when having asthma symptoms Never encourage a child to tough it out when having asthma symptoms

40 Medications

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

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

43 Rescue Or Reliever Medications Are taken when asthma symptoms are appearing (asthma episode) Are taken when asthma symptoms are appearing (asthma episode) Are taken minutes before strenuous exercise/activity by children with EIA Are taken minutes before strenuous exercise/activity by children with EIA Do NOT reduce or prevent swelling from developing in the lungs 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! 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 MDIs (Metered dose inhalers) must be used with a spacer or holding chamber Most MDIs (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 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 The physician must write an order for it when prescribing your reliever medication Dry powder inhalers do NOT require spacers 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 students lungs are doing at that moment Measures how well the students lungs are doing at that moment Associated with the Green-Yellow-Red system of managing asthma symptoms Associated with the Green-Yellow-Red system of managing asthma symptoms Congruent with asthma action plans Congruent with asthma action plans Helps students and families self-manage asthma Helps students and families self-manage asthma

50 Symptoms and PFM Diary

51 Asthma Action Plan (AAP)

52 Asthma Action Plan Zones Asthma Action Plan Zones Green Zone: All Clear/Breathing Good/Go Green Zone: All Clear/Breathing Good/Go –No asthma symptoms and/or –Peak flow % Yellow Zone: Caution/Slow Down Yellow Zone: Caution/Slow Down –Some asthma symptoms and/or –Peak flow 50-80% Red Zone: Medical Alert/Stop Red Zone: Medical Alert/Stop –Severe asthma symptoms and/or –Peak flow < 50%

53 Working Together

54 Successful Asthma Management Requires Everyone's Cooperation Teachers Teachers Parents Parents Students Students Medical Providers Coaches All School Personnel Talk with your school Nurse to find out what you can do to help manage asthma in your school

55 YOU Can Make A Difference!


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