Transcript What is Asthma? - Natomas Unified School District

Managing Asthma In
The School Setting
Natomas Unified School District
What You Need To Know
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What is asthma?
What happens during an asthma episode
What can cause an asthma episode
Early warning signs of an asthma episode
What to do if a child is having an “asthma attack”
When to call 911
How to use a peak flow meter
How to use an inhaler
What is Asthma?
• Asthma is a CHRONIC lung disease that affects
people of all ages and race.
• It is caused by inflammation (swelling) of the
lining of the airways (windpipes).
• The inflammation causes the airway to narrow
(bronchoconstriction) and makes it difficult to
breathe.
• The lungs produce excessive mucus, further
narrowing the airways.
What is Asthma?
• Asthma often begins in childhood (it is
frequently associated with an allergic
reaction) however, it can develop at anytime
in life.
• Currently there is no cure for asthma. It is a
breathing problem that a person has to live
with for the rest of his/her life. With proper
care asthma can be controlled and allows a
person to live a full normal life.
What is Asthma?
Asthma is a disease that:
• Is chronic
• Produces recurring episodes of breathing
problems
– Coughing
– Wheezing
– Chest tightness
– Shortness of breath
• Cannot be cured, but can be controlled
Cost of Asthma
• Quality of life (sick most of the time if not
controlled)
• Education (Leading cause of school absences)
– Over 14 million school day missed
• Work
– Productivity (parents, other caretaker)
• Hospital/ER Visits
– $13 Billion dollars
An Asthma Episode (“Asthma Attack”)
• When a person has trouble breathing
because of asthma, the problem is in the
airways of the lungs.
• The airways become narrow because they
are swollen. This is caused by:
– Tightening of the muscles around the
airways;
– Swelling of the lining of the airways;
– The lungs produces mucus that clogs the
small airways.
An Asthma Episode (“Asthma Attack”)
• The airways become:
– smaller (spasm)
– inflamed (swollen)
– traps air
– Produces extra mucus
An Asthma Episode (“Asthma Attack”)
• Breathing gets harder as the person tries to
force air through the narrower airways.
• The air the person breathes may make a
wheezing or whistling sounds, and may cause
them to cough or spit up mucus.
• An asthma episode is a problem that can be
life threatening if not taken care of right way.
What Can Cause An Asthma Episode
• Asthma episode is caused by certain factors
known as triggers.
• Asthma triggers differ from child to child.
• These triggers falls into 3 general categories:
– Allergens
– Irritants
– Physical Conditions
Allergens
• Allergens – are the most common cause of
asthma attacks. They are usually inhaled.
• Allergens include but are not limited to:
– Warm-blooded pet dander (dogs, cats, birds, and
small rodents)
– House dust mites
– Cockroaches
– Pollens from grass and trees
– Molds (indoors and outdoors)
Irritants
• Irritants – things that a person can be exposed to:
– Cigarette smoke, wood smoke, wood dust
– Scented products (hair spray, perfume,
cosmetics…etc.)
– Cleaning products (glass cleaners, bathroom cleaners,
laundry detergents…etc.)
– Strong odors from fresh paint or cooking
– Automobile fumes and air pollution
– Chemicals (pesticides, lawn treatments…etc.)
Physical Conditions
• Physical Conditions:
– Infections in the upper airways, such as colds
(a common trigger for both children and
adults)
– Exercise (exercise induced asthma)
– Strong expressions of feelings (crying,
laughing)
– Changes in weather and temperature, cold air,
dry air
– Heartburn
Early warning signs of an
asthma episode
• An asthma episode begins slowly.
• Most children feels warning signs when an
episode is starting.
• Often times an asthma episode is precipitated
by a cold or a flu.
Early Warning Signs
• Dry cough
• Feeling tired (not
wanting to play)
• Feeling sad, angry
• Trouble sleeping
• Stuffy nose, runny
nose, watery eyes
• Sneezing, itchy throat
• Stomachache
• Headache
• Fast heartbeat
• Tight chest
• Shortness of breath or
fast breathing
• Wheezing, noises
when breathing
• Ear pain
• Drop in peak flow
meter scores
What do you do if a child is
having an asthma episode
(asthma attack)?
What to do if someone has an asthma “attack”
•Evaluate the situation
•Remain calm
•Are their lips, tongue, or nail
beds turning?
•Is there a change in level of
consciousness or confusion?
•Be reassuring
Green Zone
This means the child is doing well
•No coughing
•No wheezing
•No chest tightness
•No shortness of breath
Student can go back to class
Yellow Zone
Student has a:
•Cough
•Wheezy
•Chest tightness
•Short of breath
What to do:
•Have the student sit in an
upright position.
•Check the asthma
management plan
•Check to see if the
student has a peak flow
meter and /or
inhaler at school
Yellow Zone continued…
•If he/she has a peak flow meter and/or
inhaler have them use it
as prescribed.
•Make sure to follow the doctor’s orders. How
many puffs does the order say?
•May give room temperature water to drink.
•Have them rest in the health office until they
are in the green zone.
Peak Flow Meters
Used to measure how well air moves out of the
airways.
1. Have patient stand, lips tight around the
mouthpiece, take a deep breath, hold for a
second, blow hard and fast. Take highest of
three tries.
2. Compare the highest value achieved of three
peak flow maneuvers.
3. Determine which zone they are in – Green,
Yellow or Red (Refer to next slide).
Peak Flow Averages Table
Height
in/cm
Average Peak Flow: Yellow Zone Below:
(Predicted)
(Under 80%)
Red Zone Below:
(<50% of Predicted)
43/109
147
118
74
44/112
160
128
80
45/114
173
138
87
46/117
187
150
94
47/119
200
160
100
48/122
214
171
107
49/125
227
182
114
50/127
240
192
120
51/130
254
203
127
52/132
267
214
134
53/135
280
224
140
54/137
293
234
147
55/140
307
246
154
56/142
320
256
160
57/145
334
267
167
58/147
347
278
174
59/150
360
288
180
60/152
373
298
187
61/155
387
310
194
62/157
400
320
200
63/160
413
330
207
64/163
427
342
214
65/165
440
352
220
66/168
454
363
227
Source: Adapted from “Peak Flow Values” table, Northeast Valley Health Corporation and
“Expected Peak Flow Table” California Asthma Public Health Initiative, 2006, www.caasthma.org.
Peak Flow Meters
Metered Dose Inhaler
• A metered dose inhaler (MDI) is a small handheld devise that allows the child to breath in a
fine mist of medicine.
• A spacer is a holding chamber that holds the
medicine before the child takes in a slow
breath.
• Always use a spacer, if available. This will help
get the right amount of medicine from each
puff.
How to use an Inhaler
1. Make sure the child is standing.
2. Remove the cap. With the inhaler in the upright
position, insert the mouthpiece of the inhaler
into the spacer.
3. Shake the inhaler and spacer well right before
each puff.
4. Put the mouthpiece of the spacer in the child’s
mouth. Ensure the child seals his or her lips
around the mouthpiece and, when ready,
gently breathe out.
How to use an Inhaler
5. Instruct the child to breathe in slowly and
deeply as the inhaler is pressed to release 1
puff.
6. Instruct the child to hold his breath for 5 to
10 seconds.
7. If the child is to take more than one puff, wait
1 minute and then repeat steps 3 to 6.
Yellow Zone continued…
•If symptoms do not clear up after using the
inhaler contact parent/guardian.
•If no inhaler is available contact
parent/guardian to bring one of pick student
up.
•Have the student stay indoors during recess,
lunch recess, and PE if the air quality is poor.
Red Zone
•Student is VERY short of breath
OR
•The inhaler did not work
•Trouble walking or talking
due to shortness of breath
•Lips and/or fingernails are
blue
Red Zone continued…
•Are symptoms worsening?
•Are they having difficulty
speaking in full sentences?
•Loud wheezes or persistent
cough
•Is there a decreased level of
consciousness?
Signs of difficulty breathing
•Rapid or shallow breathing
•Not able to speak in full sentences
•Wheezing (high pitched sound)
•Tightness in the chest
Signs of difficulty breathing
continued…
•Widening of the nostrils
•Increased use of stomach and chest muscles
•Excessive coughing
•Appears very anxious
When to call 9-1-1
•Symptoms are getting worse
•Signs of difficulty breathing
•Decreased level of consciousness
•Lips, tongue, or nail beds are blue
Resources
• Allergy and Asthma
Network/Mothers of Asthmatics
1-800-878-4403
www.aanma.org
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• American College of Allergy, Asthma
and Immunology 1-800-842-7777
www.allergy.mcg.edu
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• American Lung Association
1800-586-4872
www.lungusa.org
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Asthma & Allergy Foundation of
America (AAFA)
1-800-727-8462
www.aafa.org
Lung, Line, National Jewish Medical
Research Center 1-800-222-5864
www.njc.org
National Institute of Allergy and
Infectious Disease
1-301496-5717
www.niaid.nih.gov
National Asthma Education and
Prevention Program National Heart,
Lung and Blood Institute
1-301592-8573
www.nhlbi.nih.gov
Asthma Training Documentation Check-List for School Personnel
Employee Name:___________________________________________________Date:_______________
School:______________________________________________________________________________
As a school employee who provides emergency medical assistance to students with asthma who are
experiencing difficulty breathing, it is necessary that you receive adequate training and document that
you have been trained to provide this assistance. The person providing the training must be a school
nurse, public health nurse, registered nurse, or physician. In addition to the first training, you will receive
periodic review and retraining annually. If for any reason you feel that you are not adequately trained,
need a review, and are unable to continue to provide this assistance, or have any questions, immediately
contact your school nurse, trainer, and/or supervising site or district administrator. If you hear from the
student’s parent/guardian or physician that any of the written orders for care have changed, immediately
contact your school nurse, other trainer or supervising site or district administrator for clarification
regarding your role in the changing needs for the student.
Skill
Date Received
Training
Reads physician’s written orders for the student.
Watches Asthma power point presentation
Completes Asthma Pre and Post-tests
Demonstrates how to use a peak flow meter and inhaler.
I certify that the above employee has been trained to assist students during an asthma episode (“asthma
attack”) and is competent to respond appropriately in the event such an emergency.
_____________________________________________________________________________________
Signature of School Nurse/Trainer
Date
_____________________________________________________________________________________
Printed Name of School Nurse/Trainer
I certify that I have received the training above and feel that I am competent to provide emergency
assistance to a student experiencing an asthma episode. I agree that if I have any questions or learn of any
changes in the physician’s written orders for the student, I will immediately contact the school nurse,
other trainer or supervising site or district administrator.
_____________________________________________________________________________________
Signature of Designated Trained School Personnel
Date
Date Received Training
Asthma'Pre/Post'Test'
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1)!Asthma!is!a!chronic!inflammatory!disease!that!causes!the!airways!of!the!lungs!to!do!all!of!the!following!
EXCEPT:!!
a. swell!up!
b. narrow!
c. dry!up!
d. fill!up!with!mucous!
2)!When!the!lungs!overreact!to!swell!or!tighten!up!it!is!usually!caused!by!a!stimulus!often!referred!to!as!a:!!
a. cause!
b. trigger!
c. initiator!
d. activator!
3)!Which!of!the!following!can!lead!to!common!signs!and!symptoms!of!asthma?:!!
a. dust!
b. strenuous!exercise!
c. polluted!air!
d. all!of!the!above!
4)!Common!signs!and!symptoms!of!asthma!are:!!
a. coughing!
b. wheezing!
c. increased!energy!
d. a!and!b!
5)!In!order!to!prevent!asthma!attacks!a!person!should!try!and!do!all!the!following!EXCEPT:!!
a. avoid!triggers!
b. Keep!surroundings!as!free!as!possible!from!asthma!triggers.!
c. Take!medications!only!when!he!or!she!feels!like!it.!
d. Have!an!action!plan!
6)!The!purpose!of!using!a!spacer!with!a!metered!dose!inhaler!is:!!
a. To!provide!a!stronger!dosage!of!a!medication!to!the!person.!
b. To!lengthen!the!time!span!of!the!medication’s!effects!on!the!body.!
c. To!enhance!inhalation!of!medication!in!those!not!coordinated!enough!to!do!so.!
7)!Asthma!is!a!chronic!inflammatory!disease!that!causes!the!airways!of!the!lungs!to!dilate,!widen,!and!dry!
up.!!
True!or!False!
8)!How!a!person!reacts!to!his!or!her!asthma!condition!may!depend!on!how!narrow!the!airways!get!at!any!
given!time.!
True!or!False!
9)!A!common!quickUrelief!medication!is!called!albuterol,!and!it!also!goes!by!names!like!ProAir,!Proventil,!
and!Ventolin.!
True!or!False!
10)!By!knowing!the!signs!and!symptoms!of!an!asthma!attack!a!person!is!better!able!to!know!when!it!is!
time!to!get!help.!
True!or!False!
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