One-in-ten children in Kentucky suffers from asthma, and U.S. students miss nearly 15,000,000 total school days per year according to the Kentucky.gov website.
Belinda Stivers, Eminence Independent Schools’ nurse for more than a decade said she has seen the numbers rise dramatically in her tenure. “Every year it increases,” she said.
Stivers said she wants to research the problem in Eminence and devise a plan to combat asthma-related absences this school year. “Lots of kids miss school with it,” she said. “The first month of school I see more because of hot weather and allergens.”
Dr. Kenneth Gardner of Family Physician Associates in Eminence said children with asthma who are sensitive to outdoor allergens should be careful this time of year. “In the last couple weeks we have seen an increased number of seasonal attacks,” he said.
Stivers’ plan of attack begins with questions. Is the child out of medication? Does the student need nebulizer treatments, but is not aware the school nurse can administer those? Do they use their inhalers correctly? She said the answers to those kinds of questions will help devise individual asthma plans for students.
One tool already in use is a form completed by the student’s physician and kept on file at schools. The Primary Care Provider Authorization form gives personal information regarding a child’s asthma history and medical needs.
It identifies what triggers an attack. Common triggers include weather changes, exercise, pollens, food, animals or even chalk dust. Stivers said that much of the asthma seen in older students is exercise-induced.
Signs and symptoms are recorded such as coughing, wheezing, shortness of breath, feeling frightened, unable to speak sentences without taking a breath.
Measures to be taken for the child are then prescribed such as using an inhaler or nebulizer treatment.
Gardner said gaining control of asthma attacks by using allergy pills, inhalers or even shots is vital. “Prevention is the name of the game,” he said.
Stivers said school health services can provide a range of support to families dealing with childhood asthma, but some parents are not aware of available services. “Another goal is to let them know I’m here,” she said.
She will work with a student and family to develop an asthma action plan to use at school. Part of that plan is for students to either carry an inhaler at school or to have one accessible. A child with exercise-induced asthma would be encouraged to use an inhaler prior to playing sports or participating in physical education.
The nurse also can assist the family with adherence to the child’s prescribed medication plan by having set times for the student to take meds in her presence.
She will work with families to decrease student absences due to asthma through compliance with physicians’ plan of care.
In the classroom, Stivers said teacher awareness is the first line of defense. “Early intervention is key,” Stivers said. “Staff is trained on opening day to recognize symptoms of asthma.” She said when a student begins coughing and not feeling well, teachers know to have the child use his inhaler or refer him to the nurse’s office for evaluation. The goal is to avoid a full-blown asthma attack. “Teachers are very proactive,” Stivers said.
Eventually she hopes to offer asthma seminars at the family resource center in Eminence because ultimately, she believes education is the key to caring for students with asthma. “There is always room for more education,” Stivers said.
She also considers teamwork between the school nurse, parents, teachers and physician is essential. “Having a nurse in the building to look at and work individually with students’ needs works,” Stivers said. “We have to limit flare-ups,” Gardner said. “That’s what gets kids into trouble with their asthma.”
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