• What Are Your Asthma Triggers?
    With spring around the corner (hopefully!) we should all be aware of the many triggers, or causes of asthma attacks. Asthma is very prevalent not only in U-46 but in schools across the country. Some areas have more than 20 percent of their students dealing with asthma symptoms. Uncontrolled asthma has many negative consequences including students missing school. Let's take a look at what triggers asthma and ways to help our students remain in school, healthy and able to learn.

    Prevalence
    Close to 10 percent of all children in the United States have been diagnosed with asthma. 1 Asthma has caused over 1 million hospital and emergency room visits per year and millions of school days are missed due to asthma attacks. 2 What is asthma and how can it be controlled?

    What is Asthma
    Asthma is a disease that affects your breathing. More specifically, it affects the airways – causing them to swell and restrict airflow into and out of your lungs. There is no known cause for asthma but there are ways to control it. There are many negative consequences of uncontrolled asthma. Asthma symptoms can interrupt sleep at night causing sleepy, unprepared students during the day. The medicines used to prevent asthma can also cause drowsiness during the day. There is a great deal of anxiety associated with asthma. Students with asthma are concerned about participating in activities, worried about the next attack. Other students, teachers and staff are concerned for students who suffer attacks in school. Asthma action plans help prevent asthma attacks and prepare the student to deal with asthma by defining their specific asthma triggers.

    What are Asthma Triggers
    There are many asthma triggers or events, substances that can bring on an asthma attack. There are common triggers, but every person with asthma will have their own unique set of factors that may bring on an asthma episode. It is important for students who have bouts of breathing trouble to see their physician and develop an asthma action plan. An action plan will point out what triggers your attacks and how to deal with them.

    We as parents, teachers, maintenance personnel, school nurses and students should be aware of the common asthma episode triggers. Although we cannot remove them all, we can be aware of them. The student who knows what triggers his asthma is better able to prevent an asthma attack.

    The most common cause of asthma episodes is the common cold or other respiratory infections. 3 Good hand washing is a very effective way to prevent colds. Let's promote good hand washing in school and home – remember use warm water and soap – lather 20 seconds – and rinse.

    Dust mites are another common cause of asthma episodes. Dust mites are found in carpets, mattresses, pillows, clothes, stuffed toys and fabric-covered items. Most homes and schools in humid areas have dust mites. 4 Encase your pillow with a dust-proof cover. Wash sheets, pillow cases, blankets and stuffed toys once a week in hot water. Use dehumidifiers and air conditioning to reduce the indoor humidity. 5

    Prevent mold in the classroom. Do not let surfaces remain wet more than 24 hours. And watch out for cockroaches and other pests. Droppings and remains of cockroaches is a common cause of asthma episodes. Prevent bugs by keeping food and garbage sealed in plastic bags. Never leave food out in the kitchen or classroom. 6

    Allergens, those things that trigger allergic reactions such as a runny nose and itchy watery eyes can also cause asthma attacks. Seasonal allergies many times are brought on by the changes of the season from winter to spring and again from summer to fall. When pollen and outdoor mold counts are high, consider staying indoors and keep windows closed. Check with your doctor to see if you should consider taking a medicine to prevent allergic reactions to pollens and molds, before the season starts. 7

    Animals with fur are known to cause problems for asthma. Teachers, consider having fish or reptiles for class pets – hamsters, mice, all furry animals can cause problems for the student with asthma.

    Strong odors – perfume, although lovely to smell for some, can cause an attack for the student with asthma. Watch out for air fresheners, body creams, and perfumes. 8 Diesel exhaust coming in through open windows – do the buses pull up next to your classroom? Leave the windows closed at that time.

    Without treatment, most students with asthma have some difficulty breathing with physical activity. Some children only experience asthma symptoms during or after physical activity. This is referred to as exercise induced asthma (or EIA). EIA may be worsened by breathing colder, dryer air. It can be prevented by taking a bronchodilator, such as albuterol, 15 minutes prior to exercise. It may also be prevented by warm-up and cool-down exercises. 9

    Strong expressions of feelings, such as crying, laughing hard, or yelling can cause some student's asthma to flare up. 10

     
    Signs & Symptoms 11
    According to the NEA's online course “Managing Asthma in the School Environment” The signs and symptoms of an asthma attack include:
    • Shortness of breath – students may complain of feeling winded, or unable to catch their breath.
    • Wheezing – wheezing sounds like a high-pitched, raspy whistle. You may hear the wheeze when the person exhales. As an asthma episode progresses, you may hear the wheeze when the person inhales and exhales. There is one more key point about wheezing. During an asthma episode when the chest is tight, the absence of wheezing may mean that there is very little air moving through the lungs and the student is having a severe asthma episode or asthma attack.
    • Tightness in the chest is another sign – some students may describe this sensation as heaviness in the chest. You may even see them attempt to press down on their chest in an attempt to alleviate the pressure.
    • Coughing at night, after physical activity, or a cough that lasts more than a week, in the absence of a respiratory infection, is another sign. Coughing can also be a warning sign of an impending episode for some people with asthma.
    • Signs of a student with a severe attack include struggling to breathe, talk, or stay awake, blue lips, or if the student asks for an ambulance.
    Action Plan
    See your doctor if your child is dealing with any of these symptoms. Alert your school's nurse and your child's teachers if your child has asthma. Click on the health forms below and print. 

    Annual Asthma Assessment
    Asthma Action Plan
    Asthma medication permission and physician instruction - English
    Asthma medication permission and physician instruction - Spanish
     
    Have your physician fill out the information regarding the level of asthma and the medicines and treatments necessary to control it. Fill out the parent/guardian portion of these forms. Bring these forms in along with any inhaler or medicine that needs to be taken at school and give them to your school's Direct Service Nurse.
     
    Feel free to call the Direct Service Nurse at your child's school. She has information on working with asthma in school and can help answer your questions. She will also coordinate the care needed to keep you child in good health and staying in school.
    Submitted by Peggy Courser, RN, Direct Service Nurse for Tefft Middle School

    References:
    1, 3, 4, 8, 9, 10, 11 The National Education Association; NEA, Health Information Network; &
    Merck Childhood Asthma Network. (2010). Managing asthma in the school
    environment: what NEA members need to know. NEA Academy course , http://www.neaacademy.org/leader-to-leader/managing-asthma-in-the-school-
    environment-what-nea-members-need-to-know.html
    2 Akinbami, M.D., L. J., Moorman, M.S., J. E., & Liu, M.Sc., X. (2011). Asthma prevalence,
    health care use, and mortality: United States, 2005–2009. National Health Statistics
    Reports , 32 . Retrieved from http://www.cdc.gov/nchs/data/nhsr/nhsr032.pdf
    5, 6, 7 U.S. Department of Health & Human Services, National Heart Lung and Blood Institute
    National Institutes of health. (2007). Asthma action plan (NIH Publication No. 07-
    5251). Bethesda , MD : Retrieved from http://www.nhlbi.nih.gov/health/public/
    lung/asthma/actionplan_text.htm