Managing Child's Asthma at School

Introduction

A prevalent long-term condition, asthma, impacts the pediatric and adolescent population. Research indicates that approximately 10 % of children experience asthma, making it a leading contributor to school absenteeism. An asthma episode occurs when a child is exposed to certain environmental factors (asthma triggers), like smoke, dust, pollen, etc. Taking proper physician-prescribed medications and avoiding triggers can help control asthma.

How Can Parents Prepare Their Asthmatic Child for School?

Parents can prepare their asthmatic child for school by taking the following steps:

• Firstly make an appointment with the child’s physician and discuss the concerns regarding the child’s general health, asthma, and other issues.

• Update medical prescription forms.

• Update asthma action plan (school forms and care plans).

• Provide the school written permission to discuss the child’s health with the physician.

• Take an asthma control test for the child, which helps the physician evaluate the child’s symptoms (whether or under control).

• Before the school opens (before the first day), make an appointment with the school nurse or staff to discuss the child’s asthmatic issues, health, medications, and asthma action plan.

• A healthcare professional provides an individualized written treatment plan called an asthma action plan, which includes instructions on managing asthma effectively. It also contains information on what to do if symptoms get worse and on what to do during exercise.

• The school nurse or staff should receive up-to-date information on prescribed medications and asthma action plans.

• Study the school’s asthma policies and emergency procedures. Enquire about the availability of quick-relief inhalers at school and whether the child can carry the same.

• Understand the school’s initiatives in preventing COVID-19 and other infections. These include information on social distancing, masking, ventilation, and cleaning.

• The child should not be sent to school if the following symptoms are present:

• Asthmatic problems significantly affect a child’s sleep (sleepless nights).

• Severe wheezing.

• Shortness of breath.

• Severe coughing.

• An asthmatic episode that can not be controlled with quick relief medications.

When Should a Child Report to the Staff?

The school staff, including teachers, should be able to identify asthmatic symptoms.

The child should report to the teacher in case of the following symptoms:

• Wheezing (a whistling sound during breathing).

• Fatigue (increased weakness).

• Severe coughing.

• Chest tightness.

• Shortness of breath.

What Are the Steps the School Authorities Should Take?

To create an asthma-safe and healthy environment, the school authorities should take the following steps:

• An Asthma-Friendly School:

An asthma-friendly school initiative includes tools and a framework that takes a comprehensive approach to asthma management. These include education programs, policy recommendations, and planning tools to create a healthy learning environment.

• Asthmatic Medications in School:

Asthma management in kids involves a shared responsibility of the parents, school authorities, and the child’s physician. The child should be provided access to quick-relief medications at school, as it is where the child stays the most during the day. Students should be allowed to carry quick relief medication to school.

• Self-Management Interventions:

Self-Management interventions include asthma self-management education programs for teenagers (ages 11 to 16), conducted in an interactive and fun way. One such approach is called Kickin’ Asthma. These programs help teenagers by providing information on self-management practices, helping them recognize their triggers, and information on the proper use of medications.

• Physical Education:

Proper exercises are essential for improving the physical and mental health of the child. These help in improving heart health, reducing depression, controlling weight gain, promoting good sleep, increasing muscle strength, etc. Premedication with an inhaler may be required in some cases; advice should be taken from the child’s physician before indulging in such activities. Physical education teachers and instructors should know how to prevent exercise-induced asthma and the measures to take when symptoms appear.

• Controlling Asthma Triggers:

Asthmatic triggers include substances (like dust, pollen, smoke, etc.) that can cause asthma episodes or exacerbate the symptoms.

The school may take measures to manage these triggers. The steps taken include:

• Enforce a no-smoking policy in school to avoid exposure to tobacco smoke.

• Remove animals from school if possible, or at least remove them from sensitive children.

• Regular dusting and vacuuming of school to prevent clutter formation.

• Proper pest control using Integrated Pest Management (IPM). Avoid pesticides and call maintenance staff for pest management.

• Minimize eating in the classroom to control pests. Store food in sealed containers.

• Use vinyl tile or wood flooring, and avoid using carpets.

• Enforce a non-smoking policy for school buses and other vehicles.

• No idling policies for vehicles.

• Fix leaks and dry moist areas immediately to prevent mold formation.

• Adequate Emergency Care:

The school teachers and staff should know how to recognize and respond to an asthma emergency. There should be a school-wide plan for asthma emergencies.

• Identifying the Vulnerable:

Identify and keep track of the students who have asthma. Designate the school nurse or other staff on the school asthma team. This designated person maintains the child’s asthma action plan and educates teachers and other staff on the child’s asthma action plan.

Who Takes Part in Managing the Child’s Asthma at School?

A child with asthma is susceptible to experiencing an asthma attack during various school settings, including classrooms, playgrounds, and other areas, as they spend a significant portion of their time at school. So all the school staff must be educated about asthma symptoms and emergency measures to be taken.

The school should have an asthma management team under the school nurse. The school and substitute teachers should know about the child’s condition and personal asthma action plan. Asthma can also have an impact on the overall productivity of the child. Informing the teachers of the same can help in the maximal participation of the child in school activities.

Physical education teachers should also be aware of asthma symptoms and take extra care to prevent exercise-induced asthma. They should encourage students to participate in activities as long as asthma symptoms are under control.

Conclusion

Asthma is a chronic illness that is common in children. School absenteeism is often attributed to asthma, making it a prominent factor contributing to missed school days. But, the condition can be prevented to some extent and is treatable. Asthma affects the child’s health and the child’s overall productivity. Measures taken by parents, schools, and healthcare professionals can help children cope with asthma and make schools safer and healthier.