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Asthma at School

Role of the Teacher

Identify the high-risk students with asthma:

  • Previous life-threatening episodes
  • Three or more emergency room visits in one year
  • Prior hospitalizations within one year
  • History of non-adherence to asthma treatment regimen
  • Recurrent nighttime asthma requiring medications
  • Know the early warning signs
  • Have a copy of the students Asthma Action Plan in your classroom
  • Understand the student may feel tired, different from other students, anxious
    about easy access to medications, embarrassed about asthma, worried about
    activities that induce asthma

Asthma Facts

  • Asthma is the most common chronic disease of children
  • There are approximately 22 million people in the USA diagnosed with asthma
  • Asthma is the leading cause of school absenteeism in the United States
  • Children with uncontrolled asthma miss approximately 14 days of school per year
  • Asthma education is a vital component of asthma management
  • Asthma specialists (Allergist, Pulmonologist) are needed to care for mild
    persistent, moderate persistent and severe persistent asthma
  • If properly managed, people with asthma can live a happy, healthy, active life

Early Warning Signs

  • Low peak flows
  • Chronic cough (especially at night)
  • itchy, scratchy, sore throat
  • headache, stopped up head, sneezing
  • shortness of breath with exertion restlessness, more irritable,
    or at even rest
  • dark circles under the eyes
  • restlessness, more irritable
  • increased fatigue
  • tired, itchy watery, glassy eyes

Asthma Action Plan

An action plan is a treatment plan for worsening asthma. The action plan adjusts to the severity of symptoms so that students can control their asthma. People with asthma should have a treatment and management plan developed by their health care team. An Asthma Action Plan is a special road map to know how to take care of asthma each day.

When peak flow rates are:

Green Zone
  • Everything is all "go"
  • 80% or more of what your peak flow rate should be
Yellow Zone
  • Caution
  • 60 to 80% of what your peak flow rate should be
Red Zone
  • Medical emergency - peak flow rates are less than 50% of what it should be

Peak Flow Monitoring

A peak flow meter is a device that measures how well air moves in and out of the lungs. During an asthma episode, the airways become inflamed and narrowed. Many people who take asthma medicine daily use a peak flow meter several times a day.

How to Use the Peak Flow Meter

  • Set the marker to the bottom of the numeric scale.
  • Take a deep breath. Be sure you are standing up.
  • Place your lips tight around the mouthpiece.
  • Talk a big deep breath in.
  • Blow as hard and fast as possible. Blast the air out fast!
  • Note the final position of the marker. This is your peak flow rate.

Inhalers

Metered dose inhaler:

This is a small canister that contains the medication you need to control your asthma or relieve bronchospasms during an asthma episode (Advair HFA, Symbicort, ProAir HFA, Xopenex HFA, Albuterol HFA, Flovent HFA, Q-Var HFA, etc.). Proper inhaler technique must be performed to efficiently receive the medicine.

  1. Shake inhaler and place in your spacer. You may need to remove the inhaler from the canister if your spacer requires no case.
  2. Take 2 or 3 slow and deep warm up breaths.
  3. Sit up straight and be sure you are holding your head looking straight ahead.
  4. Slowly exhale.
  5. Place inhaler in your mouth, and then spray one spray.
  6. Slowly breathe in and hold your breath at least 10 seconds.
  7. Remove the spacer from your mouth and slowly exhale.
  8. Properly place spacer back into your mouth and slowly breathe in again.
  9. Hold your breath at least 10 seconds then slowly exhale.
  10. Wait 1 to 3 minutes and repeat as ordered by your doctor. (Be sure to shake your inhaler again!) Rinse your mouth after using anti-inflammatory medications.

Dry powdered inhalers:

This is medication that is in powder form. (Advair Diskus, Pulmicort Flexhaler, Asmanex, etc.)

  1. Breathe out slowly.
  2. Put your mouth on the mouthpiece.
  3. Take a big deep breath in real fast.
  4. Hold your breath for 10 seconds.
  5. Blow out slowly.

Recent News

REAL-WORLD PRESCHOOL PEANUT ORAL IMMUNOTHERAPY EFFECTIVE AFTER ONE YEAR OF MAINTENANCE
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REAL-WORLD PRESCHOOL PEANUT ORAL IMMUNOTHERAPY EFFECTIVE AFTER ONE YEAR OF MAINTENANCE

The study, published in the AAAAI’s journal The Journal of Allergy and Clinical Immunology: In Practice, reports findings for participants who received a follow-up oral food challenge after one year on peanut daily maintenance.

MILWAUKEE, WI – Data published in The Journal of Allergy and Immunology: In Practice (JACI: In Practice), an official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI), demonstrated that peanut oral immunotherapy (OIT) is effective after one year of maintenance in preschool participants who received a follow-up oral food challenge (OFC).

Preschoolers (9-70 months old) enrolled in the real-world study were administered increasing peanut doses in a clinic every two weeks over 8-11 visits until reaching the 300mg peanut protein maintenance dose. After spending approximately 12 months taking maintenance doses, patients were invited to complete a peanut follow-up OFC.

A total of 164 patients completed build-up and three dropped out of maintenance, leaving 161 patients available for follow-up OFC. A total of 117 of the 161 eligible patients received the follow-up OFC. Among them, 92 (78.6%) were able to tolerate a cumulative peanut protein dose of 4,000mg. A total of 115 (98.3%) tolerated a cumulative 1,000mg dose at follow-up, which would protect against accidental peanut exposures.

“The main takeaway for parents is that in this study, OIT provided protection from accidental exposures for 98.3% of preschoolers,” said Lianne Soller, PhD, corresponding author of the study and University of British Columbia allergy research manager. “These data, in combination with our previous data demonstrating safety of peanut OIT in preschoolers, suggest that this therapy could be considered for this age group as an alternative to the current recommendations to avoid peanut.”

Also of note was that epinephrine use during maintenance dosing remained low with only two participants requiring it, and only 10.5% of participants experienced allergic reactions at all. During the maintenance phase, only one patient needed to go to the emergency department due to an allergic reaction.

“Our study is the first to report on effectiveness of peanut OIT in preschoolers in a real-world setting, as opposed to a clinical trial setting,” said Dr. Soller. “We plan to continue to follow-up with this cohort long-term so we can continue to strengthen and solidify our recommendations regarding peanut exposure and oral immunotherapy.”

You can learn more about the current state of oral immunotherapy at the AAAAI’s website, aaaai.org.

The American Academy of Allergy, Asthma & Immunology (AAAAI) represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

The post REAL-WORLD PRESCHOOL PEANUT ORAL IMMUNOTHERAPY EFFECTIVE AFTER ONE YEAR OF MAINTENANCE appeared first on Oklahoma Allergy and Asthma Clinic.

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